Biotechnology and genomic innovation are seen as increasingly important for achieving public health goals in Africa. In particular, vaccines based on advances in genomic technology are deemed vital in the fight against HIV/aids. Public-Private Partnerships (PPPs) provide a collaborative mechanism to ensure these vaccines are developed when the private sector lacks incentives to develop these products. These partnerships provide new mechanisms for transferring the knowledge required to ensure vaccine development occurs as quickly and efficiently as possible. One such accine partnership (...) is the South African AIDS Vaccine Initiative (SAAVI). This has been successful in ensuring 'value added' (benefit gained by taking part) is created for those involved particularly in the area of intangible value added determinants of collaboration and knowledge capacity. This paper outlines the results of a case study of SAAVI and argues that it provides evidence of a need to strengthen our understanding of the linkage between wider conceptual 'systems' of innovation and health. In particular, it espouses the usefulness of 'Systems of Innovation' thinking as a means to ensure that more specific focus is placed on process outputs such as collaboration and knowledge capacity. This will ensure that necessary knowledge flow is transferred between those working in the vaccine project for more efficient and effective operations. The research also raises questions about the possibility of such case studies highlighting areas of attention that need addressing if greater linkage is to occur between innovation and health at a wider health research policy level. (shrink)

Contemporary culture trivializes the "seven deadly sins," or vices, as if they have no serious moral or spiritual implications. Glittering Vices clears this misconception by exploring the traditional meanings of gluttony, sloth, lust, and others. It offers a brief history of how the vices were compiled and an eye opening explication of how each sin manifests itself in various destructive behaviors. Readers gain practical understanding of how the vices shape our culture today and how to correctly identify and eliminate the (...) deeply rooted patterns of sin that are work in their own lives. This accessible book is essential for any reader interested in spiritual disciplines and character formation. Excerpt Very simply, a virtue (or vice) is acquired through practice repeated activity that increases our proficiency at the activity and gradually forms our character. . . . We often need external incentives and sanctions to get us through the initial stages of the process, when our old, entrenched desires still pull us toward the opposite behavior. But with encouragement, discipline, and often a role model or mentor, practice can make things feel more natural and enjoyable as we gradually develop the internal values and desires corresponding to our outward behavior. Virtue often develops, that is, from the outside in. This is why, when we want to reform our character from vice to virtue, we often need to practice and persevere in regular spiritual disciplines and formational practices for a lengthy period of time. (shrink)

It is proposed that the Darwinian theoretical approach and account of living systems has not yet been clearly given. A first approximation to this is attempted, focussing on behavior in evolving environments. A theoretical terminology is defined emphasizing the mutuality of organism and environment and the existence of biologically theoretical entities.

Professors are increasingly encouraged to adopt multiple role relationships with their students. Regardless of professor intent, these relationships carry risks. Left unexamined is whether student–faculty social multiple relationships impact student in-class behaviors. Provocatively, our exploratory study provides empirical support suggesting that when undergraduate students perceive that their professors engage in the multiple faculty–student relationships of friendships, drinking (alcohol) relationships, and sexual partnerships, students report they are more likely to engage in uncivil behaviors in the professor’s classroom. Accordingly, our study provides (...) a backdrop against which to think more substantively about the professorial role and the boundaries that accompany it. (shrink)

Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

In the article “On Avoiding Deep Dementia,” Norman Cantor defends a position that I suspect many readers share. In my years writing and speaking on advance directives and dementia, I've found that most people support one of two positions. They are convinced either that advance choices should control the treatment dementia patients receive or that the welfare of a person with dementia should sometimes take priority over earlier choices. As Cantor points out, I support the second position.I agree with several (...) of Cantor's arguments. Where Cantor and I part ways is over the degree of control that advance directives should exert over the care of persons with moderate dementia. Although I don't welcome the prospect of living with dementia, I believe that people with the condition should be represented in the debate over treatment standards. It's not surprising that many, perhaps most, people unaffected by dementia think that their preferences should control the care they would receive as dementia patients. But people taking this position are neglecting the concerns and interests they may have as dementia patients. (shrink)

There is an apparent epidemic of mental illness. At the end of 2011, untreated mental disorders accounted for 13% of the total global burden of disease, and for 25.3% and 33.5% of all years lived with a disability in low-and middle-income countries, respectively. Depression affects 350 million people globally and is the leading cause of disability. One in five U.S. adults takes psychiatric medication. One study found that by age 32, 50% of people surveyed qualified for an anxiety disorder, more (...) than 40% for a mood disorder, and more than 30% for substance dependence. Another study reported that... (shrink)

"Patient advocates can help make research more ethical, but advocacy raises ethical issues of its own.

Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

Some research is too risky to be conducted on anyone whose life expectancy is more than a few hours. Yet sometimes, the research can still be carried out using subjects who are brain dead or are soon to undergo a terminal wean, and who have articulated values that inclusion in the study can honor. So argues a team of ethicists and researchers at M.D. Anderson Cancer Center, where such research was recently undertaken.

I discuss theories about the way in which we determine the precedence ofperceived events. I examine Mellor’s account, which claims that it is thetiming of our perceptions of events that enables us to determine their order,and Dennett’s criticism of this. Dennett cites psychological experimentswhich suggest that it is the content of our perceptions, rather than theirtiming, which allows us to determine the order of the events perceived. Iargue that by distinguishing between two different ways of construing‘perception’ we can see not (...) only that the two accounts are compatible, but that Dennett’s account presupposes Mellor’s. (shrink)

The important roles of prediction and prior experience are well established in music research and fit well with Clark's concept of unified perception, cognition, and action arising from hierarchical, bidirectional predictive processing. However, in order to fully account for human musical intelligence, Clark needs to further consider the powerful and variable role of affect in relation to prediction error.

The climate crisis is beset by depoliticization. Couched as an issue that experts must solve through technological or technocratic knowledge, discussion about how to address environmental degradation is not amenable to democratic action or dissensus. This paper argues that approaching climate change through a human rights framework risks reinscribing such depoliticization and that this is politically hazardous. Human rights discourse can impede the demos’ exercise of power, obscure exercises of hegemony, and, via a fixed notion of progress, discourage normative contestation. (...) This discourse’s depoliticizing potential is further attested to by the debate over human rights’ relationship to the depoliticizing ideology of neoliberalism. Moreover, beyond the language of human rights, the larger legal phenomena of judicialization and juridification may further contribute to depoliticization. Depoliticization is risky because it can provoke politicizing backlashes likely to issue, in the case of climate change, in antidemocratically nationalistic and authoritarian responses to the environmental emergency. (shrink)

Pigovian policy is developed in economic theory as an efficient resolution to externality problems. The use of this type of policy to resolve real-world externality problems, including climate change in the form of carbon taxes, assumes that the Pigovian policy result derived in theory holds in the real world. By examining the bridging conditions from theory to the real world, I argue that this assumption holds only in an ambiguously defined subset of externalities. It is thus unclear when Pigovian policy (...) could be coherently applied, which is problematic given its widespread use in critical policy contexts. (shrink)

In this paper, I argue for the sense of touch as primary in Aristotle’s account of sensation. Touch, as the identifying and inaugurating distinction of sensate beings, is both of utmost importance to Aristotle as well as highly aporetic on his explanation. The issue of touch and the problematic of flesh, in particular, bring us to Merleau-Ponty’s account of flesh as the chiasmic fold and overlap of subject and object, of self and other, and to an incipient and veiled knowledge (...) present in the body’s orientation to and within the world. (shrink)

We provide a study of Russell’s argument (in _An Inquiry into Meaning and Truth_) against naive realism in which we distinguish five different forms of the argument. We agree with McLendon’s (1956) criticism, that Russell’s premiss that naive realism _leads to physics_ (our emphasis) is ambiguous as between “leads historically or psychologically” and “leads logically”. However, physics does logically lead to naive realism, in the sense that it presupposes it. In that case it is physics that is false. There is (...) also the possibility that physics and naive realism are compatible, and that possibility obtains if phenomenalism is true. (shrink)

The recent decision of the House of Lords in Stack v. Dowden appears, at first sight, to endorse a new approach to the jointly owned family home. However, upon closer inspection, this proves to be something of an illusion: the new approach is remarkably similar to the traditional resulting trust in that it attaches more weight to financial payments than to other contributions. A further problem is that the disjunction between the reasoning of the judges and the actual result makes (...) it a difficult decision to apply to future cases. This case-note will consider the legal and social issues raised by the case and will argue that it has the potential to disadvantage women who do not make an equal financial contribution to the purchase of the home. (shrink)

In Ghaidan v. Godin-Mendoza [2004] U.K.H.L. 30, the U.K. House of Lords upheld the right of a man to succeed to the tenancy of his deceased same-sex partner as if he had been the husband or wife of the deceased. This note examines the five judgements delivered by the court and considers the implications of the decision. It argues that, within the context of family law, Mendoza was a welcome decision but an evolutionary dead-end. The case signals a more promising (...) approach to the development of human rights, but the appropriate use and scope of s.3 of the Human Rights Act 1998 remain somewhat unclear. (shrink)

New Zealand has an unspoken commandment: ‘thou shalt not be a tall poppy’. A tall poppy is someone who stands out from the crowd, usually by excelling at one or more pursuits. Sadly, many New Zealanders are all too familiar with this phrase as they have been ‘cut down’ by those around them, taunted for their success and discouraged from celebrating their achievements. This social phenomenon of cutting down tall poppies is called Tall Poppy Syndrome and is present in many (...) areas of New Zealand culture, such as sport, academic achievement, and entrepreneurship. Consequently, the church is not immune to this phenomenon. Tall Poppy Syndrome, whether within or outside the church, discourages excellence and prevents flourishing. This article engages Moral Foundations Theory to understand why Tall Poppy Syndrome exists in New Zealand, and then proposes Christian humility as a remedy for Tall Poppy Syndrome within the church. When humility and excellence can co-exist, then Tall Poppy Syndrome will no longer exist; thus the church could have an important role in enabling New Zealand to be a place where tall poppies can freely flourish. (shrink)

This essay outlines the kinds of evidence available (and not available) for studies of ancient Mediterranean pandemics, the scholarship on the subject so far, and some reflections on the relationship between the two. The focus is on the three largescale epidemic episodes that have attracted the most scholarly attention: the “Plague of Athens” in the fifth century BCE; the “Antonine Plague,” which spread across the Roman Empire in the late second century CE; and the “Justinianic Plague,” which first engulfed the (...) Mediterranean in the sixth century CE. All present considerable evidential challenges. There are traditional resources and the rich remains of ancient medical writings, but we also now have at our disposal new archaeological and genetic evidence. The research questions on these pandemics must be expanded beyond asking what disease was implicated and what political and economic impact its Mediterranean outbreaks had, sometimes within quite a restricted geographical area. Interdisciplinary research will be required to answer these wider enquiries fully. All the salient disciplines need to be involved, with due attention to their methodologies, if the field is to move forward and make the most of its resources. (shrink)

Over the last three decades, the application of evolutionary theory to the human sciences has shown remarkable growth. This growth has also been characterised by a ‘splitting’ process, with the emergence of distinct sub-disciplines, most notably: Human Behavioural Ecology (HBE), Evolutionary Psychology (EP) and studies of Cultural Evolution (CE). Multiple applications of evolutionary ideas to the human sciences are undoubtedly a good thing, demonstrating the usefulness of this approach to human affairs. Nevertheless, this fracture has been associated with considerable tension, (...) a lack of integration, and sometimes outright conflict between researchers. In recent years however, there have been clear signs of hope that a synthesis of the human evolutionary behavioural sciences is underway. Here, we briefly review the history of the debate, both its theoretical and practical causes; then provide evidence that the field is currently becoming more integrated, as the traditional boundaries between sub-disciplines become blurred. This article constitutes the first paper under the new editorship of the Journal of Evolutionary Psychology, which aims to further this integration by explicitly providing a forum for integrated work. (shrink)

It gives me great pleasure to introduce the December 2013 issue of the Kennedy Institute of Ethics Journal—our ninety-second!—and to introduce myself as the new Editor-in-Chief of the journal. For almost a quarter of a century, from its special vantage point in Washington, D.C., and at Georgetown University’s Joseph and Rose Kennedy Institute of Ethics, the KIEJ has served as a leading source for practically engaged, policy-relevant philosophical work in bioethics, broadly construed. Under the expert stewardship of Robert Veatch and (...) Carol Spicer, the journal built a top-quality research legacy. It is with pride and anticipation that I take the helm.While I am committed to honoring and building on our past, I am .. (shrink)

Les images en couverture de ces deux livres saisissent de manière remarquable certains des grands thèmes dont ils traitent : pour l’étude des colonies de vacances de Laura Lee Downs,on a choisi une série de clichés où garçons et filles s’embarquent dans le train pour les colonies ou jouent allègrement en plein air.Le livre de Susan B. Whitney sur les mouvements de jeunesse reproduit une affiche du comité de liaison des jeunes du Front populaire, où l’on voit de jeunes couples (...) qui marchent sou... (shrink)

What is the relation between scientific explanation and understanding? The thesis investigates a notion of understanding that is believed to be central to scientific explanation. The role of understanding in explanation is double: it is both an essential component, as well as a criterion, by which we select bona fide explanations from non-explanations. The model of explanation that is outlined in the thesis is a version of the unificationist model of explanation. In the thesis, this model is compared to Hempel's (...) covering law model. The two models share some assumptions, but as it turns out, the unificationist model has more resources and is better suited to meet some of the objections that have been thought to be detrimental to the covering law model. The final part of the thesis is an investigation of theory reduction. The contention is that reduction is best accounted for as a sort of explanation, and it is argued that as such, it is best understood within the framework of the unificationist model of explanation that is outlined in the first part of the thesis. (shrink)

Decision-making is a prominent theme in this edition of the Journal of Medical Ethics. Our feature article examines the relationship between trust and informed consent. Informed consent is, of course, central to the decision-making process in medicine. In addition, several articles consider decision-making in medicine from a variety of angles.Informed consent and trust: Eyal's argumentIn our feature article, Nir Eyal attacks attempts by bioethicists including Onora O'Neill, Torbjörn Tännsjö, and Jennifer Jackson to ground the importance of informed consent in its (...) role in safeguarding trust in medical practice . The trust-promotion argument for informed consent, as Eyal terms it, states that trust in medical practice is necessary to ensure that people seek and comply with medical advice and participate in medical research, that as a result it is ‘usually wrong to jeopardise that trust’, that violations of informed consent jeopardise that trust, and that standard informed consent requirements are therefore justified.Eyal makes explicit that this argument is consequentialist: it takes the value of informed consent to lie in its role in ensuring trust in medical practice; in turn, trust is instrumentally valuable because it promotes health through use of the medical system, compliance with treatment, and participation in research . The consequentialist trust-promotion argument, Eyal observes, differs from deontological trust-based arguments, which defend respecting informed consent requirements with reference to factors such as its being an appropriate way of honouring the trust that patients place in doctors.Eyal attacks the trust-promotion argument on the ground that it does not account for some commonsense intuitions about informed consent. He argues, to cite one of the many problems he raises, that secret breaches of informed consent—for example, treating patients while they sleep—would …. (shrink)