Genetic results are usually not returned to research participants in Uganda despite their increased demand. We report on researchers’ perceptions and experiences of return of individual genetic research results. The study involved 15 in-depth interviews of investigators involved in genetics and/or genomic research. A thematic approach was used to interpret the results. The four themes that emerged from the data were the need for return of individual results including incidental findings, community engagement and the consenting process, implications and challenges to (...) return of individual results. While researchers are willing to return clinically significant genetic results to research participants, they remain unsure of how this should be implemented. Suggestions to aid implementation of return of results included reconsenting of participants before receiving individual genetic results and increasing access to genetic counseling services. Community engagement to determine community perceptions and individual preferences for the return of results, and also prepare participants to safely receive results emerged as another way to support return of results. Researchers have a positive attitude toward the return of clinically significant genetic results to research participants. There is need to develop national guidance on genetic research and also build capacity for clinical genetics and genetic counseling. (shrink)

Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching (...) Hospitals in a low resource setting. (shrink)

This study aimed to explore stakeholders’ perspectives on the ethical considerations for returning individual pharmacogenomics research results to people living with HIV. A qualitative approach to investigation involved five focus group discussions with 30 Community representatives, 12 key informant interviews with researchers, and 12 in-depth interviews with research ethics committee members. In total, 54 stakeholders who were involved in pharmacogenomics research and HIV treatment and care contributed to the data collection between September 2021 and February 2022. The study explored five (...) prominent themes: (i) defining the nature of research results to return to participants; (ii) preparing research participants to receive their results; (iii) obtaining informed consent for the return of results; (iv) opinions on health personnel to return the results to participants; and (v) opinions on how research results should be communicated to participants. Respondents identified various strategies for the return of individual results with minimal ethical risks including the setting up of a diverse and independent committee to undertake a risk-benefit assessment based on local context; ongoing discussions about the possible kinds of results and their implications throughout the study; and employing genetic counsellors to communicate results to participants. The strategies identified in this study should be further studied and independently verified. (shrink)

Research Ethics, Volume 18, Issue 3, Page 193-209, July 2022. This study aimed to explore experiences and practices of key research team members in obtaining informed consent for pharmacogenetics research and to identify the approaches used for enhancing understanding during the consenting process. Data collection involved 15 qualitative, in-depth interviews with key researchers who were involved in obtaining informed consent from HIV infected individuals in Uganda for participation in pharmacogenetic clinical trials. The study explored two prominent themes: approaches used to (...) convey information and enhance research participants’ understanding and challenges faced during the consenting process. Several barriers and facilitators for obtaining consent were identified. Innovative and potentially effective consenting strategies were identified in this study that should be studied and independently verified. (shrink)

Journal of Political Philosophy, EarlyView.

In the canonical view of the corporation, management is the agent of the owners of the corporation-the stockholders-and, as such, has a fiduciary duty to manage the corporation in their best interests. Most business ethicists condemn this arrangement as morally indefensible because it fails to respect the right of other corporate constituencies or “stakeholders” to self-deterrnination. By contrast, the modern agency theory of the firm provides a defense of this arrangement on the grounds that it is the result of stakeholders’ (...) right to self-determination. This paper uses the exarnple of managers’ fiduciary duty to stockholders to argue that different normative judgrnents often mask empirical disagreements. (shrink)

We suggest that there is a need for those who seek to explore issues associated with the implementation of citizenship education in England to clarify its specific nature. This can be done, at least in part, through a process of comparison. To that end we review some of the connections and disjunctions between 'character education' and 'citizenship education'. We argue, drawing from US and UK literature but focusing our attention on contexts and issues in England, that there are indeed some (...) broad areas of overlap between these two fields. Citizens should be of 'good' character and the educational initiatives that we consider both emerge from a concern about current trends in society. However, we suggest that the overlaps with citizenship education principally apply when character education is drawn very broadly. When we examine a particular approach to character education that is often US-based, and titled as 'citizenship', we note many contrasts with citizenship education as formulated in the National Curriculum for England. We suggest that citizenship educators in England need to interpret claims about the similarity between these two fields with caution, or meanings that apply to both character education and citizenship education will be distorted. (shrink)

Can we achieve greater fairness by reforming the corporation? Some recent progressive critics of the corporation arguethat we can achieve greater social justice both inside and outside the corporation by simply rewriting or reinterpreting corporate rulesto favor non-stockholders over stockholders. But the progressive program for reforming the corporation rests on a critical assumption,which I challenge in this essay, namely that the rules of the corporation matter, so that changing them can effect a lasting redistribution of wealth from stockholders to non-stockholders. (...) This essay uses a critique of the progressive reform program to argue that the rules ofthe corporation are distributively neutral. The corporation isn't rigged against non-stockholders, and changing its rules will not improve the bargaining power of non-stockholders. However, while the rules may be epiphenomenal from the standpoint of distributive justice, they can have substantial impacts on the corporation's efficiency. As a result, the proposed reforms may hurt the corporation's capacity to generate benefits for all the parties concerned. (shrink)

This paper is a critique of ‘integrative medicine’ as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of ‘integrative medicine’ defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus’ account is then considered in the light of Zuzana Parusnikova’s recent criticism of ‘integrative medicine’ and (...) her distinction between ‘cognitive’ and ‘opportunistic’ engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of ‘dogmatism’ and proposes that one can usefully invoke Karl Popper’s ‘critical rationalism’ as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that ‘integrative medicine’ can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova’s appeal to Popper should be augmented with Paul Feyerabend’s emphasis upon the role of ‘radical alternatives’ in maximising criticism. ‘Integrative medicine’ fails to maximise criticism because it ‘translates’ alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable ‘radical alternatives’. These claims are then illustrated with a discussion of ‘traditional’ and ‘medical’ acupuncture. I conclude that ‘integrative medicine’ fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress. (shrink)

This paper reassesses the role of sceptical thinking in the emergence of the new science of the seventeenth century, in the context of the seminal but contestable History of Scepticism by Richard Popkin. It investigates the anti-sceptical essay by Galen De optimo modo docendi, which was retranslated in the sixteenth century by Erasmus and later published as an adjunct to the works of Sextus Empiricus, in order to highlight the currency of ideas about hyperbolic doubt, and links this to the (...) long tradition of free enquiry in which doubting authority is seen as a profitable exercise closely associated with the independence of philosophy from theological domination; and it argues that this long tradition played an important role in the emergence of the new science. (shrink)

You never reach the Body without Organs, you can't reach it, you are forever attaining it, it is a limit. People ask, So what is this BwO? - But you're already on it, scurrying like vermin, grouping like a blind person, or running like a lunatic: desert traveller and nomad of the steppes. On it we sleep, live our waking lives, fight - fight and are fought - seek our place, experience untold happiness and fabulous defeats; on it we penetrate (...) and are penetrated; on it we love. (Deleuze and Guattari, 1987: 150). (shrink)

Controversial and amusing, this collection of Kennedy's writings illuminates the rights, duties, and liabilities of doctors as well as other aspects of medical law and ethics.

This book investigates theories of interpretation and meaning in Renaissance jurisprudence.

This paper maintains that at the heart of the post-Reformation debates over the extra Calvinisticum lies the question of what it means to name God’s presence in the world – that is, to say where God is. Because the Lutheran position insists that there can be no proper identification of God’s presence in the world that does not take its bearings from talk about Jesus’ presence, it serves as a means of preventing Christian God-talk from becoming detached from the flesh-and-blood (...) realities of human existence. In this way, the denial of the extra Calvinisticum is a corollary of a theology of the cross – that is, the principle that talk about God is normed by the concrete reality of Jesus. At the same time, the Lutheran genus maiestaticum is rejected as making just the sort of move to which Luther himself objected in the doctrine of transubstantiation: a metaphysical explanation of Jesus’ presence in the world rather than a simple appeal to miracle. (shrink)

In a recent article in this journal, Steve Clarke and Adrian Walsh propose a normative basis for John Dupré’s criticisms of scientific imperialism, namely, that scientific imperialism can cause a discipline to fail to progress in ways that it otherwise would have. This proposal is based on two presuppositions: one, that scientific disciplines have developmental teleologies, and two, that these teleologies are optimal. I argue that we should reject both of these presuppositions and so conclude that Clarke and Walsh’s proposal (...) is insufficiently warranted for it to provide a normative basis for criticisms of scientific imperialism. (shrink)

This paper aims to encourage and guide greater engagement between contemporary vice epistemology and the work of intellectual and social historians. My view is that studies of the nature and significance of epistemic vices can be enriched by engaging with the methods and results of the historians who share our interest in epistemic character and its failings. Naturally, enrichment incurs certain costs, including complications about the nature, significance, and identity of epistemic vices as they have been conceived in different times (...) and cultures. Epistemic vices have histories that are worth our attention. I think, too, that adopting a historically informed approach to studying epistemic vices also means asking new questions and rethinking some of accepted answers. So, more work, but much fruit. (shrink)

Life can be non-ideal in many ways. One of the central ways is in its necessarily embodied, and hence vulnerable, nature. This vulnerability includes our susceptibility to injury and disease, other types of bodily failure, and death. In this chapter, we will describe the moral and epistemic mistreatment common to the experiences of illnesses. We use the term ‘illness’ here to denote serious and life-changing irreversible conditions, which may be chronic or acute. What we say may be applicable, at least (...) in part, to mental illness as well, but there are important differences. (shrink)

This book examines the goals of civic education in liberal democracy, and demonstrates how we can recognize the value of the kinds of character formation that civic education has traditionally involved without losing the portion of the truth that can be found in the orthodox view which favors critical autonomy.

This article sets out to investigate aspects of the uptake of Renaissance law and medicine from some of the logical and natural-philosophical components of the university arts course. Medicine is shown to have a much laxer operative logic than law, reflecting its commitment to the theory of idiosyncrasy as opposed to the demands made upon the law by the need for a uniform application of justice. Symptomatic of the different uptake arc the contrasting meanings of "regulariter" and "generaliter" in the (...) two disciplines. Whereas the law treats the rule as inviolable and the exception as only valid if made explicit in due legal form, medicine is able to conceive of a nature as a field of knowledge broader than that encompassed by its rules of art. Both law and medicine approach evidence. (shrink)

We explore two special challenges indigenous peoples pose to the idea of sovereigns as trustees for humanity. The first challenge is rooted in a colonial history during which a trusteeship model of sovereignty served as an enabler of paternalistic colonial policies. The challenge is to show that the trusteeship model is not irreparably colonial in nature. The second challenge, which emerges from the first, is to specify the scope and nature of indigenous peoples’ sovereignty within the trusteeship model. Whereas the (...) interaction between states and foreign nationals is the locus of cosmopolitan law, the relationship between states and indigenous peoples is distinctive. In the ordinary cosmopolitan case, foreign nationals do not purport to possess legal authority. Indigenous peoples often do make such a claim, pitting their claim to authority against the state’s. We discuss how international law has attempted to come to grips with indigenous sovereignty by requiring states to include indigenous peoples in decision-making processes that affect their historical lands and rights. A crucial fault line in the jurisprudence, however, separates a duty to consult indigenous peoples from a duty to acquire their free, prior and informed consent. The latter but not the former recognizes that indigenous peoples possess a veto over state projects on their lands, in effect recognizing in them a limited co-legislative power. We focus on recent jurisprudence from the Inter-American Court of Human Rights, and consider whether either the duty to consult or FPIC are enough to dispel the shadow of the trusteeship model’s colonial past. We suggest that they are a move in the right direction, and that implicitly they represent international law’s recognition that states are no longer the sole bearers of sovereignty at international law. In limited circumstances, international law recognizes indigenous peoples as sovereign actors. (shrink)

This paper examines recent communitarian writing about the market. Much of this work explains the loss of community in our times as a result of the expansion of the market and market values. As the market has invaded other domains, such as family andneighborhood, relationships there have become infected by the instability and transience that characterize market relations. Centralto this critique of the market is the view that the market is unable to sustain lasting commitments. This paper tests this hypothesis (...) byexamining the fate of the family—the paradigmatic case of commitment—in three separate historical periods when market orcommercial values were especially dominant. It then extends the analysis to two other component institutions of community—voluntaryand charitable activities. Finally, it examines institutions where so-called market values should presumably hold unchallenged sway,namely in the work place and the marketplace. The paper finds that communitarian values appear to thrive in market society. Instead ofbeing a juggernaut the market may be an endangered species. (shrink)

ABSTRACT This narrative synthesis based on a literature review undertaken for the project ?Creating Citizenship Communities? (funded by the Esmée Fairbairn Foundation) includes discussion, principally, about what research evidence tells us about young people?s definitions of community, of types of engagement by different groups of young people, actions by schools and what they might do in the future to promote engagement. Community is seen as a highly significant and contested area. Young people are viewed negatively by adults but are in (...) some contexts already positively engaged in communities. There seem to be gaps in the literature about what young people understand about community. There is, broadly, some consensus about how to promote engagement. (shrink)

In this chapter, I offer an account of Midgley‘s critique of scientism that converges on the claim that, among its many faults, scientism is objectionable because it does science an injustice.

I argue that religious elementary schools whose pedagogical methods satisfy the principle of rational authority have distinctive advantages over secular elementary schools for the purpose of laying the foundations for ethical autonomy in the children of religious parents. Insights from developmental psychology bolster the argument from conceptual analysis. Before children have the cognitive capacities to engage in authentically autonomous reflection, their long-run interest in developing autonomy is best served by developing their understanding of and provisional identity within their primary culture (...) and by encouraging a limited form of ethical reasoning within the framework provided by that secure cultural identity. (shrink)

Journal of Social Philosophy, EarlyView.

Ian Fraser assesses the human qualities of the three saints who are celebrated for their contribution to Christianity in Britain. He also examines some contemporary issues related to their struggle to live faith fully.

Evidence-Based Medicine (EBM) has now been part of the dominant medical paradigm for 15 years, and has been frequently debated and progressively modified. One question about EBM that has not yet been considered systematically, and is now particularly timely, is the question of the novelty, or otherwise, of the principles and practices of EBM. We argue that answering this question, and the related question of whether EBM-type principles and practices are unique to medicine, sheds new light on EBM and has (...) practical implications for those involved in all EBM. This is because one's answer to the question (whether explicit or implicit) affects the amount and type of funding and attention received by EBM, the extent to which EBM, and the generation, judgment and use of evidence more generally, can be appropriated by certain groups and questioned by others, and the extent to which truly unique socio-political developments in evidence, and in medicine more generally, are recognized and harnessed. (shrink)

This article takes a critical approach to emotion regulation suggesting that the concept needs supplementing with a relational position on the generation and restraint of emotion. I chart the relational approach to emotion, challenging the “two-step” model of emotion regulation. From this, a more interdisciplinary approach to emotion is developed using concepts from social science to show the limits of instrumental, individualistic, and cognitivist orientations in the psychology of emotion regulation, centred on appraisal theory. Using a social interactionist approach I (...) develop an ontological position in which social relations form the fundamental contexts in which emotions are generated, toned, and restrained, so that regulation is decentred and seen as just one moment or aspect in the relational patterning of emotion. (shrink)

This volume is devoted to a reappraisal of the philosophy of Paul Feyerabend. It has four aims. The first is to reassess his already well-known work from the 1960s and 1970s in light of contemporary developments in the history and philosophy of science. The second is to explore themes in his neglected later work, including recently published and previously unavailable writings. The third is to assess the contributions that Feyerabend can make to contemporary debate, on topics such as perspectivism, realism, (...) and political philosophy of science. The fourth and final aim is to reconsider FeyerabendÕs place within the history of philosophy of science in the light of new scholarship. (shrink)

The Dreyfus account of seven stages of learning is considered in the context of the Dreyfus account of five stages of skill development. The two new stages, Mastery and Practical Wisdom, make more explicit certain themes implicit in the five‐stage account. In this way Dreyfus encourages a more reflexive approach. The themes now more explicit are, in part, derived from Aristotle on phronesis, but are also influenced by Heidegger and Foucault on cultural dimensions of meaning and value. The paper considers (...) whether Dreyfus’ revised account tends towards a relativism of different worlds of meaning, disclosed through personal commitment. A more reflexive account of phronesis, it is suggested, needs to clarify the potentiality of phronesis for co‐ordination as it promotes patterns of unity in difference and difference in unity. (shrink)