The American Journal of Bioethics, Volume 11, Issue 6, Page 65-66, June 2011.

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Paul C. Taylor provides an accessible guide to a well-travelled but still-mysterious area of the contemporary social landscape. The result is the first philosophical introduction to the field of race theory and to a non-biological and situational notion of race. Provides the first philosophical introduction to the field of race theory. Outlines the main features and implications of race-thinking; asks questions such as: What is race-thinking? Don’t we know better than to talk about race now? Are there any races? (...) What is it like to have a racial identity? Engages with the ideas of such important figures as Linda Alcoff, K. Anthony Appiah, W.E.B. Du Bois, Howard Winant, and Naomi Zack. Explores the enduring significance of race in relation to culture, personal relationships and social justice. (shrink)

The Nursing and Midwifery Council, the United Kingdom regulator of nursing and midwifery has recently revised its professional code of practice. This article begins by arguing that a professional code must be capable of sustaining close reading and of action guidance. Using four exemplar clauses, it is argued that the new revised code does not meet this purpose. First, I show that in setting out requirements for consent and documentation, the meaning of the relevant clause has changed significantly during the (...) editing process so that a literal reading of the final document bears little relation to established professional practice. Second, I argue that the clause concerning the nature of professional relationships has also been altered during the editing process so that it is inconsistent with other professional groups and established accounts of the professional nurse–patient relationship. Third, I argue that the clause concerning disclosure of confidential information, which survived revision and editing with its meaning intact, is nevertheless factually incorrect and inconsistent with UK law and authoritative guidance. Finally, fourth, I argue that use of the word ‘inappropriate’ is inappropriate as it amounts to meaningless circularity, discussed in relation to a clause on expressing personal beliefs. Taken together, these examples demonstrate that the Code is seriously flawed and does not fulfil its purpose. One way that simple prescriptive clauses in the Code can be usefully understood is through the provision of detailed guidance. I argue that the Nursing and Midwifery Council has changed its position on its view of the value of guidance and has significantly reduced the amount of written guidance and advice it provides. The article concludes by arguing that in order to meet its action directing function, further clarifying revision and the provision of detailed guidance is required. (shrink)

This essay uses the concept of reconstruction to make an argument and an intervention in relation to the practice and study of black aesthetics. The argument will have to do with the parochialism of John Dewey, the institutional inertia of professional philosophy, the aesthetic dimensions of the US politics of reconstruction, the centrality of reconstructionist politics to the black aesthetic tradition, and the staging of a reconstructionist argument in the film, Black Panther (Coogler 2018). The intervention aims to address the (...) fact that arguments like these tend not to register properly because of certain reflexive and customary limits on some common forms of philosophical inquiry. The sort of professional philosophy I was raised to practise and value tends not to be particularly inclusive and open-minded, especially when it comes to subjects that bear directly on the thoughts, lives, and practices of people racialized as black. black aesthetics, by contrast, is an inherently ecumenical enterprise, reaching across disciplinary and demographic boundaries to build communities of practice and exchange. Hence the need for an intervention: to create the space for arguments and the people who work with them to function across disciplinary and demographic contexts. (shrink)

The tight connection between racial identities and roots has been called into question in recent years. The tensions between roots and routes and between authenticity and instability frame one of the central problem‐spaces in the black aesthetic tradition. In light of the role that appeals to authenticity have played in the tradition, and in light of the complications that come with those appeals, the following questions emerge: what kind of work can appeals to authenticity appropriately do; are they grounds for (...) criticism, as Lorraine Hansberry seems to think; or are they something else. This chapter addresses these questions by considering some cases such as: Sidney Kasfir's account of Germans in Yorubaland, and designs involving kente cloth. It explains at least five grades of authenticity discourse, all with their roots in the Greek word for principal or genuine (authentikós). (shrink)

Corporate social responsibility is a tortured concept. We review the current state of the art across a number of academic disciplines, from accounting to management to theology. In a world that is increasingly global and pluralistic, progress in our understanding of CSR must include theorizing around the micro-level processes practicing managers engage in when allocating resources toward social initiatives, as well as refined measurement of the outcomes of those initiatives on stakeholder and shareholder interests. Scholarship must also account for the (...) influence of diverse, and even maladaptive, stakeholders as well as more fully incorporate non-Western philosophical and economic perspectives. Based on this review, we pose five questions that scholars from each of these disciplines should address as the CSR field moves forward. We hope our questions provoke deeper thinking and greater rigor and attention to detail in this important area of business research. (shrink)

Those who know anything about black history and culture probably know that aesthetics has long been a central concern for black thinkers and activists. The Harlem Renaissance, the Negritude movement, the Black Arts Movement, and the discipline of Black British cultural studies all attest to the intimate connection between black politics and questions of style, beauty, expression, and art. And the participants in these and other movements have made art and offered analyses that wrestle with clearly philosophical issues. In _A (...) Philosophy of Black Aesthetics_, I propose to identify and explore the most significant philosophical issues that emerge from the aesthetic dimensions of black life. The book will consist of eight short chapters, each of which will discuss a complex of related themes and phenomena. Every chapter will begin with one or two illustrative real-world examples, and then use the complexities of these opening cases to introduce the relevant issues. Many people in several fields have explored various bits of the terrain that I’ll cover. But none has surveyed the entire terrain in the name of aesthetics, and none has conducted this survey from an explicitly philosophical perspective. Setting up the project in this way means that its main conclusions will come in two forms. One kind of conclusion will emerge from the way I frame the issues. The two most important points here are that the field of aesthetics ought to cover more than the study of western fine art, and that the field of black aesthetics allows and requires the sort of comprehensive and philosophical analysis that I’ll offer. Another set of conclusions will emerge from my treatment of the specific issues in each chapter. In each case the aim will be to defend, albeit briefly, some position on the major issues raised in each chapter. (shrink)

Arguments for feature creation receive support from studies of young infants forming category representations from perceptual experience. A challenge for Schyns et al. will be to determine how a feature creation system might interface with a perceptual system that appears constrained to follow organizational principles that specify how edge segments should be grouped into functional units of coherent object representations.

Altruism can be understood in terms of traditional principles of reinforcement if an outcome that is beneficial to another person reinforces the behavior of the actor who produces it. This account depends on a generalization of reinforcement across persons and might be more amenable to experimental investigation than the one proposed by Rachlin.

The World Health Organisation encourages that blood donation becomes voluntary and unremunerated, a system already operated in the UK. Drawing on public documents and videos, this paper argues that blood donation is regarded and presented as altruistic and supererogatory. In advertisements, donation is presented as something undertaken for the benefit of others, a matter attracting considerable gratitude from recipients and the collecting organisation. It is argued that regarding blood donation as an act of supererogation is wrongheaded, and an alternative account (...) of blood donation as moral obligation is presented. Two arguments are offered in support of this position. First, the principle of beneficence, understood in a broad consequentialist framework obliges donation where the benefit to the recipient is large and the cost to the donor relatively small. This argument can be applied, with differing levels of normativity, to various acts of donation. Second, the wrongness of free riding requires individuals to contribute to collective systems from which they benefit. Alone and in combination these arguments present moral reasons for donation, recognised in communication strategies elsewhere. Research is required to evaluate the potential effects on donation of a campaign which presents blood donation as moral obligation, but of wider importance is the recognition that other-regarding considerations in relation to our own as well as others’ health result in a range not only of choices but also of obligations. (shrink)

The peculiar dilemma of the self in our era has been noted by a wide range of writers, even as they have emphasized different aspects of that dilemma, such as the self’s alienation, disorientation, inflation, or fragmentation. In The Self: Beyond the Postmodern Crisis, Paul C. Vitz and Susan M. Felch bring together scholars from the disciplines of psychology, philosophy, theology, literature, biology, and physics to address the inadequacies of modern and postmodern selves and, ultimately, to suggest what an (...) alternative, “transmodern” account of the self might look like. The transmodern self, the editors argue, acknowledges meaning and purpose transcending the individual. In other words, it reflects an understanding of the human person that is not only intimately connected with the Judeo-Christian tradition but also rejects the twin delusions of absolute autonomy and cosmic meaninglessness that mark the present age. (shrink)

In 1894 the anthropologist Otis Tufton Mason called for research in an area he dubbed ‘technogeography’, and he lauded the potential benefits of the knowledge to be acquired under this heading: The...

Intentional rounding, a process involving the performance of regular checks on all patients following a standardised protocol, is being introduced widely in the United Kingdom. The process has been promoted by the Prime Minister and publicised by the Chief Nursing Officer at the Department of Health as well as by influential think tanks and individual National Health Service organisations. An evidence base is offered in justification. This article subjects the evidence base to critical scrutiny concluding that it consists of poor (...) quality studies and serial misreporting of findings and a failure to consider wider concerns, including transference of evidence to differing health-care systems, and the conflation of perception and quality of care. Political promotion and wide implementation of intentional rounding despite the flimsy and questionable evidence base raise questions about the use of evidence in ethical nursing practice and the status of nursing as an autonomous profession. (shrink)

Paul C. H. Lim offers an insightful examination of the polemical debates about the doctrine of the Trinity in seventeenth-century England, showing that this philosophical and theological re-configuration significantly impacted the politics of religion in the early modern period.

Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self‐regulating profession. This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between (...) ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical‐codes and conduct‐codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent‐centeredness. It is argued that conduct‐codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct‐codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct‐codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations. (shrink)

In this paper I shall argue that useful correspondences can be drawn between the role of depiction in showing a view of the world and the realisation that would view God as a picture of experience in the world, since both can be seen to illustrate an art of interpretation. The perceptual insight that is gleaned in mystical-philosophical consciousness converges on the idea of a realm that is marked as divine, and by exploiting mental and linguistic imagery this mindful awareness (...) can be made concrete in the form of a written text, which can be seen to be analogous to a pictorial representation. The writer of a text purportedly sees and knows the domain of divine reality through sensible and conceptual means and then reduces this consciousness to a planar form, which is observable as an artistic rendering. The reader, who is at the same time a viewer, is invited to perceptually and imaginatively attend to the artifact as a manifestation of the experient's understanding of the functional nature of God, and in this apprehension of the divine scenario in the textual picture the interpretative motif of God-in-the-painting is revealed. (shrink)

The process of condensation of an amorphous solid into a rigid matrix can often trap molecules in reversible binding sites. Exchange of the same molecular species with such sites is known to be sensitive to small chemical differences and to distinguish between enantiomers. In addition to their usefulness in chromatographic processes, such materials can separate, by solid phase extraction, specific compounds from complex mixtures. Furthermore, the trapped molecules can have their reactions guided and catalytically changed. The combination of this spontaneously (...) formed system of templates and catalytic sites may support a type of replication cycle, and suggests some pathways from simple chemistry toward the complexities of biology. © 2005 Wiley Periodicals, Inc. Complexity 11: 30–35, 2005 -/- . (shrink)

What does it mean to talk of the power of God in relation to the human self? The discourses generated by the Jewish and Christian tradition about the capacity for divinity have been mainly promulgated by men, and have more often than not served to exclude women cognitively, practically, and spiritually. As a result they have been made powerless in the face of God’s presence. It is possible to look to ideas developed in Hindu Tantra for comparative notions of power (...) (shakti) which can redeem the place of God for women. The path of divine consciousness is effectively illustrated by an imaginary and somatic awareness, by a devout attention to the play of light in the soul. In this paper I propose to read the assignment of energy and force within conceptions of divinity through the lens of a poststructuralist realization, using the work of Michel Foucault, Gilles Deleuze and Félix Guattari, and Luce Irigaray. This working paper is basically an exercise in metaphorical writing, and one reader has called it 'creative theology'. (shrink)

It is an honor to comment on Carlin Romano’s fine and ambitious book. It is also something of a challenge, precisely because of Romano’s ambition. He has set himself the task of rebranding both the United States and philosophy. He has undertaken to compose and sell an image of the United States as a distinctly philosophical enterprise, and a picture of philosophy as something more democratic and diverse than the mostly white, mostly male, elite-aspirant academic discipline that most people associate (...) with the name. This is a bold undertaking, requiring the kind of capaciousness that challenges the consumer of the analysis as much as it does the producer. This capaciousness, combined with the breezy playfulness... (shrink)

Early in World War I, Virginia Woolf wrote these words: ‘The future is dark, which is on the whole, the best thing the future can be […]’. It is tempting to assume that darkness simply hides the unknown and the threatening. It is more challenging to think of it as Woolf did: rich with possibility in even the most desperate times.We live in what many would readily describe as dark times. These times have brought (among much else) a once-in-a-century public (...) health crisis, the continued redemption of toxic white supremacy, declining trust in and support for public institutions, and growing evidence of impending climate devastation. ‘Dark Futures’ will consider some of the scenes of this devastation and mine them for insights into our predicaments and our prospects. (shrink)

Black political actors across the ideological and organizational spectrum have routinely used expressive culture to do their work and advance their causes. However, the proper relationship between cultural and political work has remained controversial, with different views becoming ascendant in different traditions and communities, and at different times within the same traditions and communities. This chapter addresses some questions register in the black aesthetic tradition. It explores W. E. B. Du Bois's iconic arguments about art and propaganda by translating the (...) arguments into the language of more or less mainstream Anglophone academic philosophy. Political questions about matters other than autonomy come to mind when one studies black aesthetics. Notions like authenticity, solidarity, identity, ownership, and memory loom large in this tradition, and each has its own web of connections to questions of power, justice, citizenship, and freedom. (shrink)