The number of online courses in business schools is growing dramatically, but little has been published about teaching business ethics courses online. This article addresses key pedagogical design, delivery, student engagement, and assessment issues that should be considered when creating a high-quality, asynchronous online business ethics course for either undergraduate or graduate business student populations. Best practices are discussed within an integrative case study approach based on the experiences of a director of online faculty development and two accomplished online business (...) ethics instructors, one teaching at a small college and the other at a research-oriented university—their successes, learning opportunities, and recommendations. (shrink)

The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries (...) and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles. (shrink)

The revised Common Rule adopts the reasonable person standard to guide research disclosure. Some members of the research community contend that the standard is confusing and ill-suited to the research oversight system. Yet the revised rule is not as radical as it might seem. During the 1970s, judges started using the standard to evaluate negligence claims brought by injured patients who said doctors had failed to obtain informed consent to the harmful procedures. In its influential Belmont Report, the National Commission (...) recommended application of a “reasonable volunteer standard” to guide IRBs evaluating research disclosures. Evidence also suggests that IRBs often invoke the reasonable person standard in deliberations about consent forms. But past application of the standard has been informal and uneven. Robust application of the reasonable person standard will require researchers and IRBs to learn more about what ordinary people want and need to know about the studies they are invited to join. Input from people with personal experience as study participants could be particularly useful to this effort. (shrink)

van der Pijl et al 1 argue that if ‘stakes are high’ and there is ‘clear conviction by the care provider’ that it is ‘necessary’, episiotomy may be given after ‘opt-out consent’. Here I caution against the applicability of their approach to vaginal examination (VE): another routine intervention in birth to which they suggest their discussion may apply. I highlight three concerns: first, the subjective and unjustified nature of assessments of ‘necessity’; second, the inadequacy of current consent practices in relation (...) to VE; and third, the significant risk of perpetuating under-recognised harms associated with unwanted or unconsented VE. I argue that opt-out consent cannot be ethically justified for VE. Its use would result in further weakening of consent practices, circumvention of individuals’ autonomy, and greater harm for women and birthing people. At the outset, it is important to recognise that the authors do not claim that their approach should be applied to VE, merely that their discussion may have relevance to consent for other interventions beyond episiotomy ‘where consent is also frequently lacking, and which are under-researched’, including VE.1 Nonetheless, it is easy to assume that episiotomy and VE are sufficiently similar that their analysis might be transferred wholesale. I disagree. There are similarities: both interventions are performed on ‘the most intimate and socially sensitive body parts’1; …. (shrink)

This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

Frente a la actual crisis de la democracia que afecta a múltiples sociedades occidentales, producto en gran medida del descontento social originado en la desigualdad que caracteriza a estas denominadas sociedades neoliberales de mercado y de consumo, el presente ensayo explora la hipótesis de que dicho resentimiento social y la crisis institucional aludida obedecen a dos instrumentos implantados por las élites con el fin no sólo de asegurar y perpetuar sus privilegios sino, más importante, para ejercer el control y la (...) disciplinación de la sociedad mediante: el rompimiento de los lazos comunitarios, por medio del individualismo y el consumismo extremos (1); y de la internalización del fracaso y la justificación de la desigualdad, a través de la meritocracia (2). (shrink)

One of six commentaries on “Obesity: Chasing an Elusive Epidemic,” by Daniel Callahan, from the January‐February 2013 issue.

An important branch of environmental theory frames the climate crisis as a moral problem in need of a moral solution: human hubris is responsible for environmental degradation and must be atoned for through humility. Politically indeterminate, however, such argumentation is vulnerable to de-politicizing and mal-politicizing capture. In an effort to fend off the threat of either, this paper turns to the history of political thought and Jean-Jacques Rousseau, who theorized the environment as both a moral and a political domain. I (...) examine how Rousseau understood the availability of republican self-rule to be contingent both on the natural environment and on the relationship we construct with it such that freedom, in his words, is not automatically ‘a fruit of every Clime.’ This is the case, he suggests, because of the environment’s intersection with political economy and political culture. At the same time, Rousseau contends, republican self-rule is also a moral practice; republican polities afford citizens a public means of achieving and exercising moral agency. Triangulating the relationship between polity, morality, and environment, Rousseau’s thought offers an integrative logic through which to imbue the environment with both moral and political salience, thereby circumventing the dangers of mere moralization alone. (shrink)

Given the prevalence of emotional and psychological problems among professional psychologists, a primary concern to the field is impairment, or problems of professional competence. Graduate students, in particular, are an especially vulnerable subpopulation of mental health care professionals. Despite graduate students' heightened risk of impairment, relatively little attention has been paid in the literature to the handling of impairment in graduate students in academic training programs. Recommendations for a proactive approach to addressing impairment in trainees are discussed with respect to (...) students, supervisors, and training programs. As graduate school is the first major milestone in a therapist's development, psychologists as gatekeepers of the field of psychology must accept an ethical responsibility to appropriately monitor, acknowledge, and manage impairment among trainees. (shrink)

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide realtime feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary (...) purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. (shrink)

This paper explores Cézanne’s art through the lens of disability gain. Disability gain defies the ability-disability binary, which defines disability as a lack of ability, by emphasizing what is gained through different disabilities. Central to my discussion are (1) Tobin Siebers’s description of modern art as vitally and thematically disabled and (2) Rosemarie Garland-Thomson’s concept of misfitting, which allows for a phenomenological account of disability that emphasizes the depth of awareness and creative world-making possibilities that are gained through disability. By (...) bringing Siebers’s approach to disability aesthetics and Garland-Thomson’s concept of misfitting into conversation with Merleau-Ponty’s “Cézanne’s Doubt” and “Eye and Mind,” I will explain how Cézanne’s unique way of perceiving the world and capturing it in paint helps Merleau-Ponty to dismantle abstract, disembodied concepts of visual perception and trace the nuanced contours of lived perspective. In other words, what is gained through Cézanne’s disabilities is a revolutionary optics that overcomes the limitations of Cartesian optics. (shrink)

Most academics in philosophy departments accept that the discipline needs to change for the better. In this piece, Rebecca Buxton and Lisa Whiting offer several proposals for how to make philosophy a more inclusive place for everyone.

Last November, soon after Colorado became the latest state to authorize physician-assisted suicide, National Public Radio's The Diane Rehm Show devoted a segment to legalization of “physician assistance in dying,” a label that refers to both physician-assisted suicide and voluntary active euthanasia. Although the segment initially focused on PAD in the context of terminal illness in general, it wasn't long before PAD's potential application to dementia patients came up. A caller said that her mother had Alzheimer's disease and was being (...) cared for at great expense. Suspecting that she will suffer the same fate, the caller reported that she had included in her will “my specific request that if I should be diagnosed, and it is legal to do so, I would like to opt out of a life and many years of suffering.” A few countries, such as the Netherlands and Belgium, already allow PAD for dementia in certain circumstances. It wouldn't be surprising to see a U.S. legalization effort in the coming years. (shrink)

Background: Nonhuman animals are regularly enhanced genomically with CRISPR and other gene editing tools as scientists aim at better models for biomedical research, more tractable agricultural animals, or animals that are otherwise well suited to a defined purpose. This study investigated how genome editors and policymakers perceived ethical or policy benefits and drawbacks for animal enhancement and how perceived benefits and drawbacks are alike, or differ from, those for human genome editing. Methods: We identified scientists through relevant literature searches as (...) well as conference presentations. Policymakers were identified through rosters of genome editing oversight groups (e.g., International Commission on the Clinical Use of Human Germline Genome Editing, World Health Organization) or efforts aimed at influencing policy (e.g., deliberative democracy groups). Interviews covered participants’ views on ethical differences between interventions affecting somatic or germline cells and distinctions between using gene editing for disease treatment, prevention, and enhancement purposes. Results: Of the 92 participants interviewed, 81 were genome editing scientists, and 33 were policymakers, with 22 interviewees being both scientists and policymakers. Multiple areas were identified in which the ethical implications of genomic enhancements for nonhuman animals differ from those for human animals including with respect to experiential welfare; germline edits; environmental sustainability; and justice. Conclusions: Overall, respondents viewed that animal enhancement is unburdened by the ethical complexities of human enhancement. These views may be related to participant perceptions of animals’ lesser moral status and because germline editing in animals is common practice. (shrink)

Craig Hanks and Aili Bresnahan are contributing editors only -- not main editors.

This paper suggests that the stories that thoroughbred breeders tell about racehorse reproduction can contribute to an understanding of their ideas about relatedness between humans. It examines the thoroughbred pedigree as it is presented in the English sales catalogue as a locus of complex ideas about heredity, fertility, and procreation. It argues that resistance within the industry to new reproductive technologies, including artificial insemination, can be understood in terms of ideas about relatedness between horses and, by implication, between people.This paper (...) is based upon extensive participant observation conducted within the horseracing industry based in the town of Newmarket, England. (shrink)

An international team of eighteen doctors, philosophers, and lawyers present a fresh and thorough discussion of the ethical, legal, and social issues raised by testing and screening for HIV and AIDS. They aim to point the way to practical advances but also to give an accessible guide for those new to the debate.

The mirror analogy in Republic X (596c-e) helps Socrates formulate the conception of mimesis used to make the argument that the painter is an imitator and his works are inferior, being thrice-removed from reality (596a-598d). The painter is classified as an impostor by an unfair assimilation with the sophistic mirror-holder. The mirror analogy and its imaging-devices give Socrates a dialectical advantage that he would not otherwise have. If Socrates succeeds with Glaucon in showing that painters are imitators, his success is (...) due primarily to the mirror analogy and its metaphorical imagery. (shrink)

In 2015 the UK became the first country in the world to legalise mitochondrial donation, a controversial germ line reproductive technology to prevent the transmission of mitochondrial disease. Dimond and Stephens track the intense period of scientific and ethical review, public consultation and parliamentary debates preceeding the decision. They draw on stakeholder accounts and public documents to explore how patients, professionals, institutions and publics mobilised within ‘for’ and ‘against’ clusters, engaging in extensive promissory, emotional, bureaucratic, ethical, embodied and clinical labour (...) to justify competing visions of an ethical future. They describe how this decision is the latest iteration of a UK sociotechnical imaginary in which the further liberalization of human embryo research and use is rendered legitimate and ethical through modes of consultation and permissive but strictly regulated licensing. Overall, this book presents a timely, multi-dimensional, and sociological account of a globally significant landmark in the history of human genetics, and will be relevant to those with an interest in genetics, Science, Technology and Society, the sociology of medicine, reproductive technology, and public policy debate. (shrink)

This article argues that Vico’s theory of history should be construed as an ontological constructionist account as opposed to its usual realist interpretation. In support of this interpretation I draw upon two important concepts issuing from the body of the Scienza nuova: the notion of ‘‘storia’’ and the verum ipsum factum principle. Both concepts are not only consistent with an ontological constructionist interpretation of Vico’s theory of history but function as powerful explanatory devices in the context of such an interpretation. (...) I show the advantage this interpretation holds for overcoming one of the main charges brought against the Scienza nuova when it is interpreted as presenting a realist conception of history. In highlighting the possibility and, indeed, textual advantages of construing Vico’s theory of history as an ontological constructionist account I claim that Vico may have anticipated the constructionist tradition by some 200 years and may be considered as the founder of constructionism in the philosophy of history. (shrink)

Introduction: Transforming Thought John McCumber The Story of Things According to an ancient story which (because of Hegel and Heidegger) we are now able to ...

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 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause protects (...) citizens’ right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied. (shrink)

This study focuses on a 12-year-old girl diagnosed with a pragmatic disorder caused by Autism Spectrum Disorder (ASD). Following an initial evaluation, a pragmatic rehabilitation program was implemented using a combined approach in 15 therapeutic sessions over a 4-month period. The program consisted of structured formats organized into modules to train the verbal, paralinguistic, and nonverbal aspects of communication. The results of the re-evaluation demonstrated the program’s effectiveness, with improvements in communicative intention, proxemic skills, prosodic variations, physical contact with the (...) interlocutor, and verbal fluency in oral messages. Consequently, the implementation of the intervention program significantly enhanced the patients’ pragmatic communication skills in therapeutic, familial, and social contexts. (shrink)