Background Community advisory boards have expanded beyond high-income countries and play an increasing role in low- and middle-income country research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics. Methods We searched five databases for publications describing or evaluating CABs in LMICs. Two researchers independently reviewed (...) articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges. Results Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa, China, and Thailand having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team. Conclusions Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs. (shrink)

This paper investigates the effect of the countervailing forces within organizations of formal systems that direct employees toward ethical acts and informal systems that direct employees toward fraudulent behavior. We study the effect of these forces on deception, a key component of fraud. The results provide support for an interactive effect of these formal and informal systems. The effectiveness of formal systems is greater when there is a strong informal “push” to do wrong; conversely, in the absence of a strong (...) push to do wrong, the strength of formal systems has little impact on fraudulent behavior. These results help to explain why the implementation of formal systems within organizations has been met with mixed results and identifies when formal systems designed to promote ethical behavior will be most efficacious. (shrink)

The integration of ethical analysis in Health Technology Assessment (HTA) has proven difficult to implement even though it is explicitly recognized as an important component of such assessments in HTA literature. When compared to the standardized scientific method for systematic reviews in HTA, the diversity of ethical analysis has been characterized as a fundamental barrier to the integration of ethics. The present paper aims to identify the theoretical and practical differences between the approaches underpinning ethical analysis in HTA and clarify (...) the reasons for such diversity. Our systematic review of HTA literature pertaining to the barriers to the integration of ethics in HTA identified nine ethical approaches: Principlism, Casuistry, Coherence Analysis, Wide Reflective Equilibrium, Axiology, the Socratic approach, the Triangular model, Constructive Technology Assessment and Social Shaping of Technology. Citations pertaining to each approach were extracted and categorized according to three constitutive components of ethical argumentation established in a previous research evaluating nanotechnologies: i) the disciplinary foundation that grounds the validity of the ethical evaluation, ii) the characteristics of such evaluation, iii) the operational process involved in applying it to a particular case (i.e., its practical reasoning). This comparison shows that, 1) the difference between these approaches rests primarily on their disciplinary foundation (rooted in philosophy, philosophy/theology, or sociology), 2) their complexity can be observed in the distinct characteristics of ethical evaluation deriving from their differing disciplinary foundation, and 3) although four different types of operationalization procedure were identified, little information was available in regards to the practical reasoning associated with these approaches. (shrink)

For over a decade, we have watched the state affairs/practitioner constituency within the American Psychological Association move steadily to become the single largest group—clearly a majority—within the membership ranks of the association. Over the same period of time and as the obverse of related demographic phenomena, the research/academic constituency has shrunk to around 30% of the membership. Since power over the affairs of and the destiny of APA has traditionally resided in the hands of the latter, it probably would have (...) been too much to hope that the visionaries in the research/academic community would have made way gracefully for new leadership to be seated in the positions of authority in the association, a leadership more attuned to the needs of APA's majority. So it is not surprising that an orderly transfer of power has not taken place. 2012 APA, all rights reserved). (shrink)

Information is a force multiplier. Knowledge of the enemy's capability and intentions may be of far more value to a military force than additional troops or firepower. Situation assessment is the ongoing process of inferring relevant information about the forces of concern in a military situation. Relevant information can include force types, firepower, location, and past, present and future course of action. Situation assessment involves the incorporation of uncertain evidence from diverse sources. These include photographs, radar scans, and other forms (...) of image intelligence, or IMINT; electronics intelligence, or ELINT, derived from characteristics (e.g., wavelength) of emissions generated by enemy equipment; communications intelligence, or COMINT, derived from the characteristics of messages sent by the enemy; and reports from human informants (HUMINT). These sources must be combined to form a model of the situation. The sheer volume of data, the ubiquity of uncertainty, the number and complexity of hypotheses to consider, the high-stakes environment, the compressed time frame, and deception and damage from hostile forces, combine to present a staggeringly complex problem. Even if one could formulate a decision problem in reasonable time, explicit determination of an optimal decision policy exceeds any reasonable computational resources. While it is tempting to drop any attempt at rational analysis and rely purely on simple heuristics, we argue that this can lead to catastrophic outcomes. We present an architecture for a ``complex decision machine'' that performs rational deliberation to make decisions in real time. We argue that resource limits require such an architecture to be grounded in simple heuristic reactive processes. We thus argue that both simple heuristics and complex decision machines are required for effective decision making in real time for complex problems. We describe an implementation of our architecture applied to the problem of military situation assessment. (shrink)

Universal Grammar (UG) can be interpreted as a constraint on the form of possible grammars (hypothesis space) or as a constraint on acquisition strategies (selection procedures). In this response to Herschensohn we reiterate the position outlined in Epstein et al. (1996a, r), that in the evaluation of L2 acquisition as a UG- constrained process the former (possible grammars/ knowledge states) is critical, not the latter. Selection procedures, on the other hand, are important in that they may have a bearing on (...) development in language acquisition. We raise the possibility that differences in first and second language acquisition pertaining to both attainment of the end-state and course of development may derive from differences in selection procedures. We further suggest that for these reasons age effects in the attainment of nativelike proficiency must necessarily be separated from UG effects. (shrink)

Aim To ascertain the quantity and nature of gifts and items provided by the pharmaceutical industry in Australia to medical specialists and to consider whether these are appropriate in terms of justifiable ethical standards, empirical research and views expressed in the literature.

The worldwide COVID-19 pandemic has shed more light on the difficulty of making health care decisions integrating scientific knowledge and values associated to life and death issues, human suffering, quality of life, economic losses, liberty of movement, etc. But the difficulties related to health care decisions and the use of innovative drugs or technologies are not new, and many countries have created agencies that have the mandate to evaluate new technologies in health care. Health Technological Assessment (HTA) reports’ aim is (...) to guide the decision makers in these difficult matters. There are two ethical components in HTA. The first is the report’s presentation of an ethical evaluation of the technology. The second is the value-ladenness of the HTA decision-making process itself. When implicit value judgments are not elicited, the justification of the final decision cannot be transparent. The present paper aims to identify and elicit the implicit value-judgments related to each step of the HTA process. This research is grounded on an applied ethics decision-making paradigm based on the role of value judgments in the decision-making process. The first part discusses two different approaches to values and value judgments in HTA. In the second part, citations mentioning value judgments extracted from a systematic review on the integration of ethics into HTA were categorized to elicit the value judgments and their criteria for each different HTA decision-making steps. The results show that there are 18 decision-making steps in the HTA process where 23 implicit value-judgments can be recognized. The range of these value judgments encompasses the whole HTA process: from the initial request, the presenting of the principal issues, to the final report’s dissemination. Since stakeholders need to understand which value judgments the conclusion of a report relies on, eliciting the implicit value judgments in the HTA decision-making process should yield more transparency. (shrink)

Sedlakova and Trachsel (2023) argue that on the one hand, conversational artificial intelligence (CAI) does not fulfill the necessary conditions for full attribution of agency, such as having consc...

Simone Weil’s political thought on labour and political community by comparing it with that of liberal and republican thinkers. Her consideration of the human need for private property and on the way that labouring produces a feeling of belonging resonates with the liberal political thought of John Locke. Locke’s thought emphasizes labour’s capacity to transform land held in common into private property and the need for political community to protect individual property rights. Weil, however, emphasizes labour’s capacity to transform individuals (...) by increasing their sensitivity to the world and capacity to attend to the needs of others. Further, the purpose of political community for Weil is to nurture human spiritual needs, including a sense of obligation to others, more than the protection of individual rights. If as C.B. Macpherson argues, liberal political thought is based on possessive individualism, then Weil’s is based on an attentive individualism. Her critique of the language of rights brings her close to a strand of republican thinking, found in Karl Marx and Hannah Arendt, which values the activation and development of human capacities through participation in political community. While Weil affirms the vital necessity of collectivity for human flourishing, she maintains a critical concern with the overvaluation of the collective in relation to the individual. In significant respects, Weil’s political thought is neither liberal nor republican and as such enables us opportunities for critical and creative reimagining of inherited political ideologies. (shrink)

In this book, Suzanne Kirschner traces the origins of contemporary psychoanalysis back to the foundations of Judaeo-Christian culture, and challenges the prevailing view that modern theories of the self mark a radical break with religious and cultural tradition. Instead, she argues, they offer an account of human development which has its beginnings in biblical theology and neoplatonic mysticism. Drawing on a wide range of religious, literary, philosophical and anthropological sources, Dr Kirschner demonstrates that current Anglo-American psychoanalytic theories are but (...) the latest version of a narrative that has been progressively secularized over the course of nearly two millennia. She displays a deep understanding of psychoanalytic theories, while at the same time raising provocative questions about their status as knowledge and as science. (shrink)

The medical record, as a managerial, historic, and legal document, serves many purposes. Although its form may be well established and many of the cases documented in it routine in medical experience, what is written in the medical record nevertheless records decisions and actions of individuals. Viewed as an interpretive text, it can itself become the object of interpretation. This essay applies literary theory and methodology to the structure, content, and writing style(s) of an actual medical record for the purpose (...) of exploring the relationship between the forms and language of medical discourse and the daily decisions surrounding medical treatment. The medical record is shown to document not only the absence of a consistent treatment plan for the patient studied but also a breakdown in communication between different health professionals caring for that patient. The paper raises questions about the kind of education being given to house staff in this instance. The essay concludes with a consideration of how such situations might be more generally avoided. (shrink)

During the 1960's and 1970's, the eruption of theory was presented as an epistemic break, reorganizing the field of questioning both prospectively and retrospectively. In the forefront of this new movement was the influential journal Tel Quel, which both canonized a body of preferred avant-garde texts (both literary and theoretical) and nullified prominent figures from preceding generations. In a broad remapping of French modernism, this book shows how the milieu of Tel Quel transferred myths of the powers of literature inherited (...) from Bataille, Sartre, Valéry, and Breton to theory, in the process erasing the traces of these myths and their common ground. The author analyzes cultural and theoretical positions—pure art, automatism, engagement, and transgression—that structured the literary and critical field from the 1920's to the 1950's to show their strong impact on the formulation and elaboration of theoretical issues in more recent decades. Focusing on the question of relations between poetry and action, she reexamines these positions and uncovers proximities between them that significantly displace theoretical issues. These proximities emerge when a philosophical subtext of Bergson—antiphilosopher and nondialectical thinker—is revealed to operate alongside the more obvious subtext of Hegel. The discourse of Bergson shifts the category of action central to these literary polemics and revalues the visual register, suggesting a reconsideration of Surrealism. The book concludes by examining the ideological pressures associated with the eclipse of the discourse of Bergson as well as some of the effects of this erasure on our understanding of the modern as distinct from the postmodern. (shrink)

Contesting Extinctions: Decolonial and Regenerative Futures critically interrogates the discursive framing of extinctions and how they relate to the systems that bring about biocultural loss. The chapters in this multidisciplinary volume examine approaches to ecological and social extinction and resurgence from a variety of fields, including environmental studies, literary studies, political science, and philosophy. Grounding their scholarship in decolonial, Indigenous, and counter-hegemonic frameworks, the contributors advocate for shifting the discursive focus from ruin to regeneration. -/- .

Has exclusion of Darwin's views on evolution distorted 20c philosophy? Cunningham suggests a reappraisal.

The Just War principle of jus ad bellum explicitly requires a reasonable prospect of success; the prevailing view about personal self-defence is that it can be justified even if the prospect of success is low. This chapter defends the existence of this distinction and goes on to explore the normative basis of this difference between defensive war and self-defence and its implications. In particular, the chapter highlights the rationale of the ‘success condition’ within Just War thinking and argues that this (...) condition is grounded in assumptions about the nature of political authority and responsibility that do not apply to personal self-defence. This important difference is commonly ignored or side-lined by contemporary theorists who regard the principles of these two types of conflict as very closely aligned and the moral differences between them as matters of degree only. (shrink)

Designed for a first course in the philosophy of mind, this book has several distinctive features.

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue (...) that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

"In recent years, we have grown accustomed to philosophical language that is intensely self-conscious and rhetorically thick, often tragic in tone. It is enlivening to read Bergson, who exerts so little rhetorical pressure while exacting such a substantial effort of thought.... Bergson's texts teach the reader to let go of entrenched intellectual habits and to begin to think differently—to think in time.... Too much and too little have been said about Bergson. Too much, because of the various appropriations of his (...) thought. Too little, because the work itself has not been carefully studied in recent decades."—from Thinking in Time Henri Bergson, whose philosophical works emphasized motion, time, and change, won the Nobel Prize for Literature in 1927. His work remains influential, particularly in the realms of philosophy, cultural studies, and new media studies. In Thinking in Time, Suzanne Guerlac provides readers with the conceptual and contextual tools necessary for informed appreciation of Bergson's work. Guerlac's straightforward philosophical expositions of two Bergson texts, Time and Free Will and Matter and Memory, focus on the notions of duration and memory—concepts that are central to the philosopher's work. Thinking in Time makes plain that it is well worth learning how to read Bergson effectively: his era and our own share important concerns. Bergson's insistence on the opposition between the automatic and the voluntary and his engagement with the notions of "the living," affect, and embodiment are especially germane to discussions of electronic culture. (shrink)

Scientists and decision makers rely on climate models for predictions concerning future climate change. Traditionally, physical processes that are key to predicting extreme events are either directly represented or indirectly represented. Scientists are now replacing physically based parameterizations with neural networks that do not represent physical processes directly or indirectly. I analyze the epistemic implications of this method and argue that it undermines the reliability of model predictions. I attribute the widespread failure in neural network generalizability to the lack of (...) process representation. The representation of climate processes adds significant and irreducible value to the reliability of climate model predictions. (shrink)

Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...) such an intervention. In this paper, we add to this proposition by discussing Moral Case Deliberation (MCD) as a specific form of clinical ethics support that promotes moral resilience. We argue that MCD in general may contribute to the moral resilience of healthcare professionals as it promotes moral agency. In addition, we focus on three specific MCD reflection methods: the Dilemma Method, the Aristotelian moral inquiry into emotions, and CURA, a method consisting of four main steps: Concentrate, Unrush, Reflect, and Act. In practice, all three methods are used by nurse ethicists or by nurses who received training to facilitate reflection sessions with these methods. We maintain that these methods also have specific elements that promote moral resilience. However, the Dilemma Method fosters dealing well with tragedy, the latter two promote moral resilience by including attention to emotions as part of the reflection process. We will end with discussing the importance of future empirical research on the impact of MCD on moral resilience, and of comparing MCD with other interventions that seek to mitigate moral distress and promote moral resilience. (shrink)

Translator's Preface LA LOGIQUE DE HUSSERL, etude sur "Logique for- melle et logique transcendentale" the original of the present translation, was published ...

A key focus in many debates surrounding the harm in hate speech centres on the subordinating impact hate speech has on its victims. Under such a view, and provided there exists a requisite level of speaker authority a particular speech situation, hate speech can be conceived as something which directly impact’s the victim’s status, and can be contrasted to the view that such speech merely expresses hateful ideas. Missing from these conceptions, however, are the ways in which intersubjective, recognition-sensitive relations (...) influence the kind of harm likely to result from such an act. Understanding the central role of first-person experience is crucial, as, while a victim may have little influence in how their social status is impacted by such an act, the possibility for ‘speaking back’ requires that individuals are equipped with the conditions necessary to reject the authority claims of the speaker. On such a view, this paper aims to use this feature of intersubjectivity to explore the potential ways in which an act of hate speech can be ‘robbed’ of some of its harm by having its authority claims rejected by the victim. Utilizing this enhanced understanding, I reflect upon one particular real-world example of hate speech, in which the target rejects the status-undermining claims made upon her. In the last section, I propose a general institutional outlook aimed towards aiding would-be victims of hate speech to respond to such attempts at normative authority exertion. (shrink)

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the (...) study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)