Caring for seriously ill and dying patients plays a key role in the patient-physician story. The emotional experience, while at times gratifying, can also be quite burdensome. In “The Inner Lives o...

The “dead-donor rule” states that, in any case of vital organ donation, the potential donor should be determined to be dead before transplantation occurs. In many countries around the world, neurological criteria can be used to legally determine death (also referred to as brain death). Nevertheless, there is considerable controversy in the bioethics literature over whether brain death is the equivalent of biological death. This international legal review demonstrates that there is considerable variability in how different jurisdictions have evolved to (...) justify the legal status of brain death and its relationship to the dead-donor rule.In this article, we chose to review approaches that are representative of many different jurisdictions—the United States takes an approach similar to that of many European countries; the United Kingdom’s approach is followed by Canada, India, and influences many other Commonwealth countries; Islamic jurisprudence is applicable to several different national laws; the Israeli approach is similar to many Western countries, but incorporates noteworthy modifications; and Japan’s relatively idiosyncratic approach has received some attention in the literature. Illuminating these different justifications may help develop respectful policies regarding organ donation within countries with diverse populations and allow for more informed debate about brain death and the deaddonor rule. (shrink)

The target article proposes a model involving the important but not well-investigated topics of curiosity and creativity. The model, however, falls short of providing convincing explanations of the basic mechanisms underlying these phenomena. We outline the importance of mechanistic thinking in dealing with the concepts outlined in this article specifically and within psychology and cognitive neuroscience in general.

Plus d’une trentaine d’années après la création des premières structures dédiées à sa promotion, l’intégrité scientifique s’est progressivement constituée en tant que thématique de recherche à part entière. Aujourd’hui, une communauté scientifique et académique est réunie autour de cet objet, comme en témoignent la publication d’un nombre croissant d’articles, la création de revues spécialisées ou encore l’organisation de conférences spécifiquement dédiées. Néanmoins, rares sont les travaux qui ont cherché à proposer une vue d’ensemble de la littérature académique relative à l’intégrité (...) scientifique. C’est dans cette perspective que cet état de l’art s’inscrit et entend apporter une contribution. Avec la volonté de rendre compte des principales tendances de la recherche en la matière, nous avons principalement ciblé dans ce travail des articles, des commentaires ou encore quelques documents institutionnels qui ont cherché à approfondir la compréhension que l’on a de l’intégrité scientifique, à explorer les diverses façons de la promouvoir, à mieux cerner l’occurrence des manquements qui y sont liés, ou encore à proposer une lecture de ces questions sous un angle spécifique. Certaines des thématiques qui sont abordées dans cet état de l’art sont incontournables dans le paysage de la recherche et font l’objet d’une attention marquée depuis longtemps, à l’image de l’étude des manquements à l’intégrité scientifique. D’autres, à l’instar des études historiques de l’intégrité scientifique, représentent des pistes de recherche un peu moins explorées mais dont l’intérêt nous semble assez important pour appeler à davantage de développements. (shrink)

Assigning a date to Kumārila is notoriously difficult. Kumārila’s dates are usually assigned through a relative chronology of Brahmanical and Buddhist philosophers with whom Kumārila engages or is engaged. This is a precarious method because the dates of these interlocutors are equally unstable. But what if in considering systematic dialogues (_śāstra_) to be the primary medium for interreligious philosophical debate we have missed a source that does engage with Kumārila, and that can be reliably dated? In this article, I turn (...) to a religious group whom, it has been previously thought, did not respond to Kumārila until the eighth century—Jainas—as well as to a genre that is not typically viewed as a site of systematic philosophical dialogue—narrative. I argue that the _Padmacarita_, a Jaina Rāmāyaṇa composed by a Digambara writer called Raviṣeṇa, contains a narrative refutation of Kumārila’s commentary to _Mīmāṃsāsūtra_ 1.1.2. By bringing to light this refutation, and explaining how Raviṣeṇa’s _Padmacarita_ can be reliably dated, I assign Kumārila’s _terminus ante quem_ to the date of the _Padmacarita_’s composition, 676 CE. Finally, I suggest that Raviṣeṇa’s _Padmacarita_ is the earliest extant Jaina text to discuss Kumārila’s claims, and that Jainas used narrative to reflect on Mīmāṃsā before they turned to _śāstra_ as another medium for this dialogue. (shrink)

Preface -- Introduction -- 1. Muslim reformists and the transition to English rule -- 2. The making of the "Indian Arab" and the tale of Sayyid Fadl -- 3. Rahmatullah Kairanwi and the Muslim cosmopolis -- 4. Haji Imdadullah Makki in Mecca -- 5. Nawab Siddiq Hasan Khan and the Muslim cosmopolis -- 6. Maulana Jafer Thanesri and the Muslim ecumene -- Conclusion -- Notes -- Acknowledgments -- Index.

This study investigated various manifestations of gravestone inscriptions to find different types of moves in the formation of such inscriptions in two Iranian social classes. The sample of the study included forty epitaphs in two shrines in the north and west of Tehran. Each epitaph was then photographed for analysis. Swales’ genre move model was used to analyze the data. The moves involved word choice, content, graphics, socio-cultural values, and written communicative practices. Considering socio-cultural factors characterizing the social classes, the (...) results revealed four moves in the epitaphs in the Shrine located in north of Tehran, and eight moves in the Shrine located in west of Tehran. Out of the total of eight moves observed, three were different in the two classes. Comparing these patterns of moves and their frequencies, various emotional, structural, lexical, gender-specific, and age-specific differences were observed. (shrink)

Papers presented at the Seminar on Ethics and Aesthetics in Indian Literary Practices, held at Udaipur in Rajasthan, India in 2009; organized by Department of English, Mohanlal Sukhadia University, Udaipur, India.

This essay argues that feminist legal theory offers an important, and underutilized, perspective to examine health law and policy. We use several theoretical frameworks developed by feminist legal theorists including relational autonomy, intersectionality, vulnerability theory, and the feminist critique of the public-private divide to demonstrate the utility of these theories to health law analysis. These frameworks provide insights relevant not only to issues that obviously relate to gender, but also to matters of choice, quality, and access that are less obviously (...) gender-related. We map three key areas of existing scholarship and future inquiry at the intersection of health law and feminist legal theory: patient choice and relational autonomy, patriarchy, power and patient safety, and access to health care and healthy living conditions at the public-private divide. Uniting these areas of inquiry is a nagging question central to the relationship between critical legal scholarship and pragmatic action to combat injustice: Can we use legal rights to achieve our aims even as we recognize them as tainted tools that have propped up oppressive social structures? A feminist agenda for health law and policy must grapple with this dilemma. (shrink)

Jesudason and Weitz's article examines two public policy debates in California, where both sides of the debate used similar language that had the potential to be detrimental to women. Specifically, they show how anti-abortion crusaders in California used similar language to describe why women's rights should be curtailed as pro-choice advocates use when fighting for more choice and privacy for women's reproductive decisions. This commentary builds upon their article by demonstrating the harm that such co-opting causes to women's rights using (...) the example of sex selective abortion. By examining the legislative history of state and national bills to ban sex-selective abortion, this commentary demonstrates how the anti-abortion lobby has adopted the language of pro-choice advocates quite effectively. Although the framing of this issue as being “woman-protective” is strategic and insincere, such political framing is powerful, as Jesudason and Weitz have noted. Anti-abortion activists have convinced lawmakers in many states that sex-selective abortion is a dire issue in their state and that they must restrict it in order to protect women. In fact, there is no evidence that sex selective abortion is a problem in the United States, yet these frames have been very effective in weakening women's privacy rights. Whenever woman-protective framings are invoked for self-serving purposes, women's rights advocates must work hard to uncover the truth behind these discourses to prevent successful legislative efforts that curtail women's reproductive freedom. (shrink)

There is limited guidance on how to assess the ethical acceptability of research risks that extend beyond research participants to third parties (or “research bystanders”). Community or stakeholder engagement has been proposed as one way to address potential harms to community members, including bystanders. Despite widespread agreement on the importance of community engagement in biomedical research, this umbrella term includes many different goals and approaches, agreement on which is ethically required or recommended for a particular context. We analyse the case (...) of a potential Zika virus human challenge trial to assess whether and how community engagement can help promote the ethical acceptability of research posing risks to bystanders. We conclude that, in addition to having intrinsic value, community engagement can improve the identification of bystander risks, effective approaches to minimizing them, and transparency about bystander risks for host communities. (shrink)

Gender representation in academic and professional settings is crucial for diversity and inclusivity. Editorial boards of scholarly journals shape research priorities, influencing global knowledge flow. In obstetrics and gynecology, with a focus on women’s health, board composition is of particular significance. This paper explores gender representation in international obstetrics and gynecology journal editorial boards, addressing potential disparities. The study adopts a cross-sectional design, analyzing the gender composition of editorial boards in global obstetrics and gynecology journals. A comprehensive search strategy identified (...) relevant journals, using databases and manual searches. Inclusion criteria ensured journals’ language of use and disciplinary scope within obstetrics and gynecology. Ethical considerations prioritized privacy and confidentiality, with data extracted systematically. Genderize.io aided in gender determination of the board members. At the time of writing, among 1175 editorial members from 20 journals, 44.8% are females. Representation varies across roles: editor-in-chief (27.27% female), deputy/executive positions (43.33% female), senior/specialized positions (50.66% female), wider/general positions (45.89% female), nonacademic positions (36% female), external academic positions (19.56% female), honorary/founding positions (33.33% female), and administrative positions (31.03% female). This study contributes a comprehensive analysis of gender representation in obstetrics and gynecology journal editorial boards. Persistent disparities across roles underscore the need for targeted interventions to foster diversity and equity. Ethical considerations emphasize the importance of addressing these disparities for social justice and research integrity. Recommendations to guide journals in fostering inclusive editorial practices, contributing to a more equitable landscape in obstetrics and gynecology research. (shrink)

Research on opioid use in pregnancy is critically important to understand how the opioid epidemic has affected a generation of children, but also raises significant ethical and legal challenges. Embedded ethicists can help to fill the gaps in ethics oversight for such research, but further guidance is needed to help strike the balance between integration and independence.

Ali Shariati is typically understood as a theorist of “political Islam.” Yet his theological innovations within what is called “mystical thought” are also worthy of attention. Shariati does not consider mystical thought as an escapist, transcendent paradigm, but as a means to interpret and navigate the socio-political world. Of particular relevance to Shariati is an idea ubiquitous across Islamic mysticism: the transformation of the self. Within Islamic mysticism, there are various iterations of the idea that to become closer to God, (...) one must enact a radical transfiguration of the self, one that occurs simultaneously at the divine and existential registers. For Shariati, this transformation of the self is tied not only to one’s relationship with God, but also to the desire to alter the social realm. This is an ethos that, for Shariati, should infiltrate all aspects of life, material and immaterial, cerebral and social. If one wishes to overturn the status quo, one must cultivate not only a revolutionary subjectivity but a mystically-oriented subjectivity as well, or one that is characterized by constant change and growth. (shrink)

This paper discusses to what extent, if any, recent street uprisings in Iran have been fuelled by gender inequalities; and, what the legal challenges of transforming such gender equality demands into the constitution are. I argue that a demographic transition that commenced two decades ago in Iran changed the status of women in family and society. Such a transition has unavoidably increased the presence of women in the public sphere and challenged gender presumptions within the law. To give a constitutional (...) response to such demands, I argue, the Iranian Constitution must re-examine the correlation between women and men as biological and/or social groups, and the relationship among women themselves as a group consisting of diverse identities. Moreover, equal attention must be paid to women’s norm, diversity, and agency. (shrink)

BackgroundTo assess ethical concerns associated with participation in a financial incentive programme to help adolescents with type 1 diabetes improve diabetes self-management.MethodsFocus groups with 46 adolescents with type 1 diabetes ages 12–17 and 38 of their parents were conducted in the Seattle, Washington metropolitan area. Semistructured focus group guides addressed ethical concerns related to the use of FI to promote change in diabetes self-management. Qualitative data were analysed and emergent themes identified.ResultsWe identified three themes related to the ethical issues adolescents (...) and parents anticipated with FI programme participation. First, FI programmes may variably change pressure and conflict in different families in ways that are not necessarily problematic. Second, the pressure to share FIs in some families and how FI payments are structured may lead to unfairness in some cases. Third, some adolescents may be likely to fabricate information in any circumstances, not simply because of FIs, but this could compromise the integrity of FI programmes relying on measures that cannot be externally verified.ConclusionsMany adolescents with type 1 diabetes and their parents see positive potential of FIs to help adolescents improve their self-management. However, ethical concerns about unfairness, potentially harmful increases in conflict/pressure and dishonesty should be addressed in the design and evaluation of FI programmes. (shrink)

This essay exposes how recent attempts at lethal injection reform have involved unethical and illegal research on prisoners. States are varying the doses and types of drugs used, developing methods designed for non-medical professionals to administer medical procedures, and gathering data or making provisions for the gathering of data to learn from executions gone wrong. When individual prisoners are executed under these conditions, states are conducting research on them. Conducting research or experimentation on prisoners in the process of reform is (...) problematic because it violates ethical frameworks and state laws. The Supreme Court has recently taken up the challenge of elucidating the standard for determining the constitutionality of lethal injection. If the Court suggests an approach to lethal injection reform that is akin to some of the more thoughtful and cautious approaches other courts have proposed, the Court's decision may also contravene state laws or ethical precepts regarding research with prisoners. Thus, this paper provides important limitations on the kinds of reform that may be permissible and outlines the open questions that must be addressed before it can be determined whether the risks and uncertainties involved in lethal injection can be remedied. (shrink)

The U.S. federal regulations require investigators conducting nonbeneficial research to obtain the assent of children who are capable of providing it. Unfortunately, there has been no analysis of which children are capable of assent or even what abilities ground the capacity to give assent. Why should investigators be required to obtain the positive agreement of some children, but not others, before enrolling them in research that does not offer a compensating potential for direct benefit? We argue that the scope of (...) children's research decision making should be based on the principles of respect for autonomy and nonmaleficence. These principles imply that the threshold for assent should be fixed at 14 years of age, and a dissent requirement should be adopted for all children in the context of nonbeneficial research. (shrink)

Imagine a study in which HIV-infected pregnant women are given antiretroviral treatment to determine how effectively it will prevent HIV transmission during childbirth. Each mother’s involvement in this study ends with the birth of her child, at which time her access to antiretrovirals provided by the study also ceases. At the outset of the study, the investigator and sponsor agree that after the child’s birth, they will refer mothers who require treatment for their HIV to a national program that provides (...) antiretroviral treatment and care. Assuming the Institutional Review Board raises no objections to this plan, should the research team consider their ethical obligations to participants fulfilled? If the investigator and sponsor were to consult the Common Rule, they would find little to suggest that there are any further ethical issues to address. (shrink)

While it is known that reward induces attentional prioritization, it is not clear what effect reward-learning has when associated with stimuli that are not fully perceived. The masked priming paradigm has been extensively used to investigate the indirect impact of brief stimuli on response behavior. Interestingly, the effect of masked primes is observed even when participants choose their responses freely. While classical theories assume this process to be automatic, recent studies have provided evidence for attentional modulations of masked priming effects. (...) Most such studies have manipulated bottom-up or top-down modes of attentional selection, but the role of “newer” forms of attentional control such as reward-learning and selection history remains unclear. In two experiments, with number and arrow primes, we examined whether reward-mediated attentional selection modulates masked priming when responses are chosen freely. In both experiments, we observed that primes associated with high-reward lead to enhanced free-choice priming compared to primes associated with no-reward. The effect was seen on both proportion of choices and response times, and was more evident in the faster responses. In the slower responses, the effect was diminished. Our study adds to the growing literature showing the susceptibility of masked priming to factors related to attention and executive control. (shrink)

Brain death, or the determination of death by neurological criteria, has been described as a legal fiction. Legal fictions are devices by which the law treats two analogous things (in this case, biological death and brain death) in the same way so that the law developed for one can also cover the other. Some scholars argue that brain death should be understood as a fiction for two reasons: the way brain death is determined does not actually satisfy legal criteria requiring (...) the permanent cessation of all brain function, and brain death is not consistent with the biological conception of death as involving the irreversible cessation of the functioning of an organism as a whole. Critics counter that the idea that brain death is a legal fiction is deceptive and undemocratic. I will argue that diagnosing brain death as a hidden legal fiction is a helpful way to understand its historical development and current status. For the legal‐fictions approach to be ethically justifiable, however, the fact that brain death is a legal fiction not aligned with the standard biological conception of death must be acknowledged and made transparent. (shrink)

The recent Ebola outbreak in West Africa began in the spring of 2014 and has since caused the deaths of over 6,000 people. Since there are no approved treatments or prevention modalities specifically targeted at Ebola Virus Disease , debate has focused on whether unproven interventions should be offered to Ebola patients outside of clinical trials. Those engaged in the debate have responded rapidly to a complex and evolving crisis, however, and this debate has not provided much opportunity for in-depth (...) analysis. Additionally, the existing literature on access to unproven therapies has focused on contexts like HIV/AIDS and oncology, which are very different than the Ebola epidemic. In this paper, we examine the ethical issues surrounding access to unproven therapies in the context of the recent Ebola outbreak to yield new insights about this controversial and unsettled issue. We argue first that, in this context, the interests of patients in obtaining access to unproven therapies are not fully aligned.. (shrink)

In many regions around the world, those at highest risk for acquiring HIV are young adults and adolescents. Young men who have sex with men in the USA are the group at greatest risk for HIV acquisition, particularly if they are part of a racial or ethnic minority group.1 Adolescent girls and young women have the highest incidence rates of any demographic subgroup in sub-Saharan Africa.2 To reverse the global AIDS pandemic’s toll on these high-risk groups, it is important to (...) deploy the most effective HIV prevention tools to young MSM in the USA, to adolescent girls and young women in sub-Saharan Africa, and to any other adolescents and young adults at high risk for HIV as products are proven to be safe and efficacious. Although prevention interventions with proven efficacy, such as oral pre-exposure prophylaxis, are available,3–8 they have not been sufficient to stem the tide and an expanded prevention toolkit is urgently needed to serve these populations. The field of HIV prevention continues to identify promising leads in the development of new biomedical prevention products, either delivering antiviral drug topically or systemically. The dapivirine ring has been shown to provide modest protection and is currently being tested in open label studies while injectable cabotegravir is being tested in a large efficacy trial for preventing HIV acquisition. Advances in the field of HIV prevention mean that scientists and regulators must plan for how they will bring prevention tools to populations at high risk for HIV as they conduct efficacy and effectiveness trials. For instance, safety data from younger age groups can also be used in combination with efficacy data from adult studies, where appropriate, as bridging studies to expand labelling to younger ages. If these …. (shrink)

Evidence suggests a limited contribution to the total research output in leading obstetrics and gynaecology journals by researchers from the developing world. Editorial bias, quality of scientific research produced and language barriers have been attributed as possible causes for this phenomenon. The aim of this study was to understand the prevalence of editorial board members based out of low and lower-middle income countries in leading journals in the field of obstetrics and gynaecology. The top 21 journals in the field of (...) obstetrics and gynaecology were selected based on their impact factor, SCImago ranking and literature search. The composition of the editorial boards of these journals was studied based on World Bank Income Criteria to understand the representation status of researchers from low and lower-middle income countries. A total of 1315 board members make up the editorial composition of leading obstetrics and gynaecology journals. The majority of these editors belong to high-income countries (n = 1148; 87.3%). Low (n = 6; 0.45%) and lower-middle income (n = 55; 4.18%) countries make up for a very minuscule proportion of editorial board members. Only a meagre 9 out of 21 journals have editorial board members from these countries (42.85%). Low and low-middle countries have poor representation in the editorial boards of leading obstetrics and gynaecology journals. Poor representation in research from these countries has grave consequences for a large proportion of the global population and multidisciplinary collaborative efforts must be taken to rapidly change this statistic with immediate effect. (shrink)

Many guidelines for international research require that studies be responsive to host community health needs or health priorities. Although responsiveness possesses great intuitive and rhetorical appeal, existing conceptions are confusing and difficult to apply. Not only are there few examples of what research the responsiveness requirement permits and what it rejects, but its application can lead to contradictory results. Because of the practical difficulties in applying responsiveness and the danger that misapplying responsiveness could harm the interests of developing countries, we (...) argue that responsiveness should be refocused in three ways: in terms of (1) who enforces it, (2) under what standard, and (3) in what cases. We conclude that responsiveness should be applied by host country officials at the policy level with the exercise of judgment when externally funded research threatens to displace scarce local resources. (shrink)

The intellectual legacy of Confucianism has loomed large in efforts to understand China's past, present, and future. While Confucian ethics has been thoroughly explored, the question remains: what exactly is Confucian political thought? Classical Confucian Political Thought returns to the classical texts of the Confucian tradition to answer this vital question. Showing how Confucian ethics and politics diverge, Loubna El Amine argues that Confucian political thought is not a direct application of Confucian moral philosophy. Instead, contrary to the conventional view (...) that Confucian rule aims to instill virtue in all members of society, El Amine demonstrates that its main aim is to promote political order. El Amine analyzes key aspects of the Confucian political vision, including the relationship between the ruler and the people, the typology of rulers, and the role of ministers and government officials. She also looks at Confucianism’s account of the mechanisms through which society is to be regulated, from welfare policies to rituals. She explains that the Confucian conception of the political leaves space open for the rule of those who are not virtuous if these rulers establish and maintain political order. She also contends that Confucians defend the duty to take part in government based on the benefits that such participation can bring to society. Classical Confucian Political Thought brings a new understanding to Confucian political theory by illustrating that it is not chiefly idealistic and centered on virtue, but rather realistic and driven by political concerns. (shrink)

In rapidly evolving medical fields where the standard of care or prevention changes frequently, guidelines are increasingly likely to conflict with what participants receive in research. Although guidelines typically set the standard of care, there are some cases in which research can justifiably deviate from guidelines. When guidelines conflict with research, an ethical issue only arises if guidelines are rigorous and should be followed. Next, it is important that the cumulative evidence and the conclusions reached by the guidelines do not (...) eliminate the need for further research. Even when guidelines are rigorous and the study still asks an important question, we argue that there may be good reasons for deviations in three cases: (1) when research poses no greater net risk than the standard of care; (2) when there is a continued need for additional evidence, for example, when subpopulations are not covered by the guidelines; and (3) less frequently, when clinical practice guidelines can be justified by the evidence, but practitioners disagree about the guidelines, and the guidelines are not consistently followed as a result. We suggest that procedural protections may be especially useful in deciding when studies in the third category can proceed. (shrink)

Sociological studies of culture have made significant progress on conceptual clarification of the concept, while remaining comparatively quiescent on questions of measurement. This study empirically examines internal conflicts (or “infighting”), a ubiquitous phenomenon in political organizing, to propose a “resinous culture framework” that holds promise for redirection. The data comprise 674 newspaper articles and more than 100 archival documents that compare internal dissent across two previously unstudied lesbian and gay Marches on Washington. Analyses reveal that activists use infighting as a (...) vehicle to engage in otherwise abstract definitional debates that provide concrete answers to questions such as who are we and what do we want. The mechanism that enables infighting to concretize these cultural concerns is its coupling with fairly mundane and routine organizational tasks. This mechanism affords one way to release the culture concept, understood here as collective self-definitions, from being “an amorphous, indescribable mist which swirls around society members,” as it was once provocatively described. (shrink)

The UNESCO research projects focusing on The Silk Routes and The Slave Routes were launched at just the right time to remind us that globalization is not a novel dimension of the history of humanity. Not only am I among those who analyze capitalism as a worldwide system from its very inception, but I have also found it pertinent to recall that prior to the sixteenth century, societies were not at all isolated from one another but rather competing within regional (...) systems (and perhaps within one global system). To underestimate this fact is to condemn ourselves to a misunderstanding of the very dynamics of change within societies. At the same time, I maintain that in the history of the world, capitalism represents a qualitative rupture that had its beginnings around 1500. Accordingly I emphasize the distinction that must be made between the integrated structure of the worldwide capitalist system and the protocapitalist elements that are to be found in earlier societies; I also underline the specificity of the contrast between centers and peripheries, which is unique to global capitalism and which differs from previous forms of polarization. (shrink)

It is shown that there are incomparable Σ2 e-degrees a, b such that every e-degree strictly less than a is also less than b.