The term ‘ethics committees’ is used for very different things in different parts of the world. In Europe, ethics committees are generally concerned only with research and (apart from Belgium where the same committees deal with both aspects) do not have anything to do with decision making in clinical situations. This article traces the history of ethics committees in the UK and some of the problems encountered by them. It goes on to detail the situation in a number of other (...) European countries. Some topics of research touched on and published in articles in Nursing Ethics are then highlighted, thus making it clear that it is written from my perspective as the Editor of Nursing Ethics and with the help of some of the members of the Editorial Board. Finally, a number of questions are asked and answers attempted concerning the interests served by ethics committees. (shrink)

The purpose of this study was to assess the degree of editorial independence at a sample of medical journals and the relationship between the journals and their owners. We surveyed the editors of 33 medical journals owned by not-for-profit organizations (“associations”), including 10 journals represented on the International Committee of Medical Journal Editors (nine of which are general medical journals) and a random sample of 23 specialist journals with high impact factors that are indexed by the Institute (...) for Scientific Information. The main outcome measures were the authority to hire, fire, and oversee the work of the editor; the editor’s tenure and financial compensation; control of the journal’s budget; publication of material about the association; and the editor’s perceptions about editorial independence and pressure over editorial content. Of the 33 editors, 23 (70%) reported having complete editorial freedom, and the remainder reported a high level of freedom (a score of ≥8, where 10 equals complete editorial freedom and 1 equals no editorial freedom). Nevertheless, a substantial minority of editors reported having received at least some pressure in recent years over editorial content from the association’s leadership (42%), senior staff (30%), or rank-and-file members (39%). The association’s board of directors has the authority to hire (48%) or fire (55%) the editor for about half of the journals, and the editor reports to the board for 10 journals (30%). Twenty-three editors (70%) are appointed for a specific term (median term =5 years). Three-fifths of the journals have no control over their profit, and the majority of journals use the association’s legal counsel and/or media relations staff. Stronger safeguards are needed to give editors protection against pressure over editorial content, including written guarantees of editorial freedom and governance structures that support those guarantees. Strong safeguards are also needed because editors may have less freedom than they believe (especially if they have not yet tested their freedom in an area of controversy). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minutes of the Annual General Meeting 2023Cornelis de Waal, Editor-in-Chief, Richard Kenneth Atkins, André De Tienne, Director and General Editor, and Elizabeth Cooke[as approved on January 17, 2024]The Annual General Meeting of the Charles S. Peirce Society was held in conjunction with the Eastern Division Meeting of the APA on January 5, 2023, at the Sheraton Le Centre, Montréal, Quebec. Rosa Maria Mayorga chaired the meeting (...) and called it to order at 12:38 p.m.1. Moment of SilenceThe annual meeting began with a moment of silence in memory of Peirce scholars who passed away in the last year.2. Approval of Minutes of the 2022 MeetingMinutes of the 2022 Annual General Meeting had been posted online. Copies were also distributed at the annual meeting. Rosa Maria Mayorga asked for a motion to approve the minutes. James Liszka so moved and Fabienne Forster seconded. The minutes were approved unanimously.3. Report from the Executive CommitteeRichard Kenneth Atkins submitted the following report.The Executive Committee Meeting was held virtually via email. All members of the Executive Committee were contacted and responded regarding the agenda and items.Agenda Items(A) Non-profit Status Update:On December 5, 2022, we received notification from the IRS that we have been legally approved as a public non-profit foundation.(B) Funding for Scholarship:Every year, we set aside a certain amount of funding for scholarship, usually 2/3rds of the year's income. This includes the $1,000 set aside for the Peirce Essay prize. Atkins reported that the income this past year was $6,597.06. 2/3rds of that is $4,400. Atkins requested that that amount of money be set aside for funding for scholarship, with which the committee unanimously agreed.(C) Next Year's AGM:Atkins proposed that we continue to hold our annual conference in conjunction with the E-APA in New York, NY, especially as this keeps us in line with the calendar year which is also our fiscal year as a nonprofit. The committee unanimously agreed. [End Page 118](D) Any Other Business:Cornelis de Waal suggested that we add to the agenda for the annual business meeting a moment of silence to commemorate Peirce scholars who passed this year. The Executive Committee unanimously agreed.4. Report from the Transactions of the Charles S. Peirce SocietyCornelis de Waal submitted the following report on behalf of the Transactions of the Charles S. Peirce Society. Richard Kenneth Atkins read the report on his behalf.During the 2022 calendar year we produced four issues of the Transactions. We encountered some problems with the first issue, because the printer suffered a ransomware attack. This apparently wreaked havoc with their system and caused significant delay in the completion of the issue.Likely due to the (after) effects of the pandemic, quality submissions to the journal were down significantly, both in the Peirce segment and in the non-Peirce segment of the journal. In addition, there was a significant drop in book reviews. The latter led to the resignation of our long-term book review editor, Henrik Rydenfelt. For the last two months I have been taking over for him, and I'm first-hand experiencing some of the challenges, even including publishers simply not following through on requests for books. We did, though, publish a book symposium on James Liszka's Charles Peirce on Ethics, Esthetics and the Normative Sciences, and we have another book symposium forthcoming on Chris Voparil's Reconstructing Pragmatism: Richard Rorty and the Classical Pragmatists. Besides a number of excellent papers on Peirce, we published some very nice papers in American philosophy. The latter include an extensive portrait of Edwin Bissell Holt, a discussion of the use of the term pragmatism in 18th century Germany, the first English translation of two texts by Wilhelm Jerusalem, as well as work on George Santayana, Jonathan Edwards, and Emily Dickinson.With Henrik gone, the editorial team is now down to Robert Lane and me (hopefully briefly returning to the traditional Robin-Hare setup). I'll be attending the upcoming SAAP meeting in Denver, and Bob is planning to attend as well... (shrink)

The present stage in the development of our society is marked by serious changes in social morality. The building of communism is entering a new stage. The man of the communist future is taking shape and being perfected before our eyes. Under these conditions, the Party - and this was emphasized at its Twenty-Fourth Congress - requires of a worker in the arts a thorough examination of contemporary life and of its hero to the full extent of his talent, and (...) demands that his ethical convictions and awareness of spirit be developed. Since this is the case, it is natural that literary criticism faces new, lofty tasks: tasks of analyzing literature in connection with those economic, societal, and moral processes which characterize social existence today. This was stated clearly both at the Party Congress and in the Resolution of the Central Committee of the CPSU "On Criticism in Literature and the Arts" [O literaturno-khudozhestvennoi kritiki]. (shrink)

Generally believed that "theory of continuing revolution under the dictatorship of the proletariat" is a "Cultural Revolution" guiding ideology, which in ten years the "Cultural Revolution" period has been widely publicized, has written to the Chinese Communists "nine", "Top Ten", "Eleventh large "by the political report and constitution, but also to write the fourth and fifth National People's Congress meeting adopted constitutional changes, the impact is huge. When it was proposed that "the history of Marxism has set a third great (...) milestone," and after more than ten years later, "since the founding of the party on a number of resolutions on the question of history" has made ​​it a completely different assessment that It is the "leftist" errors and this should be "resolutely corrected." In this paper, the editorial "October Socialist Revolution opened up along the path," CPC "nine", Hua Guofeng, the Third Plenum and "since the founding of the party on a number of resolutions on the question of history," as the coordinates of the tracking the fate of its history and study. q "The Theory on Continuing the Revolution under the Leadership of Proletarians" is commonly regarded as the guiding ideology of the Cultural Revolution. Widely publicized during the decade-long Cultural Revolution, it has been incorporated into the Chinese Communist Party's constitution and the People's Republic of China's constitution for numerous times and has exerted a great influence on the state. By the time it was initially proposed in 1967, it was regarded as' the third landmark in the history of Marxism. But it was subject to a completely different fate more than ten years later as it was labeled "pinko" and was required to he "corrected" in Resolution on Certain Questions in the History of Our Party since the Founding of the People's Republic of China. This paper aims to conduct an investigation of the historical fate of "the Theory on Continuing the Revolution under the Dictatorship of Proletarians" with reference to the following texts: Go Ahead Along the Way Inaugurated by October Socialist Revolution, Report of the Ninth National Congress of the CPC, Hua Guofeng's Talkings, Report of the Third Plenary Session of the 11th Central Committee of the Communist Party of China and Resolution on Certain Questions in the History of Our Party since the Founding of the People's Republic of China. (shrink)

I cordially thank the members of the Central Committee for the high honor they have bestowed on me-my election as General Secretary of the Central Committee. I am fully aware of the tremendous responsibility that has been placed upon me. I understand how important and how extremely complicated the work before me is. I assure the Central Committee, and the party, that I will apply all my efforts, my knowledge, and my experience to justifying this confidence (...) and, together with you, continue that fundamental line of our party that Iurii Vladimirovich Andropov consistently and persistently put into practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Transactions of the Charles S. Peirce Society 42.3 (2006) 459-461 MuseSearchJournalsThis JournalContents[Access article in PDF]Minutes of the Business Meeting Charles Sanders Peirce Society 28 December 2006Following the annual scholarly meeting, with papers by President Vincent Colapietro, "Reflective Acknowledgment and Practical Identity: Kant and Peirce on the Reflexive Stance" and Essay Contest winner Shannon Dea, "'Merely a Veil over the Living Thought': Math and Logic in Peirce's Forgotten Spinoza Review," (...) President Colapietro called the meeting to order shortly after 7 o'clock in Concourse B of the New York Hilton.The minutes of the 2003 and 2004 meetings, published in the Fall, 2004, and Summer 2005 Transactions respectively, were approved.Vincent Colapietro delivered the following report from the President and Executive Committee:André De Tienne's proposal to adopt the address of the Institute for American Thought at IUPUI as the official address of the Peirce Society was accepted.It was agreed that announcements for the Peirce Essay Contest should be placed in the Transactions and in other appropriate publications (e.g. The Journal of Speculative Philosophy and the S.A.A.P. newsletter) by mid-year if possible. It was also agreed that some length limits should be set for submitted essays and that there should be a requirement that essays meet the general standard of a submission for publication in a journal.There was discussion of the desirability of separating the collection of membership dues from subscription to the Transactions. The chief reasons for thinking that this separation might be called for are 1) the increasing availability of the Transactions through university library electronic subscriptions and 2) the higher cost of foreign subscriptions (making membership in the Society far most costly for foreign members). It was decided to revisit this issue in a year or two (after the new arrangement with IU Press has become more settled).Vincent Colapietro, Mark Migotti, and Nathan Houser were appointed to serve as a "meta" committee to form, with the approval of the Executive Committee, a "regular" committee to organize the 2014 Peirce World Congress. They will also recommend a chair for the committee and a location for the congress. Indianapolis was favored by members present.It was agreed that a list of rules and procedures for conducting Society business should be drawn up for the guidance of new Society office holders. These lists will include the rules and procedures for fulfilling the functions of the various offices, for running meetings, time-tables for making decisions, and so on. N. Houser will work on this with André Tienne and Mark Migotti to draft these lists. [End Page 459]It was agreed that the outgoing Chair of the Nominating Committee should communicate with the incoming Chair a list of the candidates who were considered but not nominated, along with the basis for consideration.Peter Hare delivered the following report on the Transactions:Starting with the fall issue, the Transactions is being published by Indiana University Press. Editorial arrangements are unchanged. Although the transition has been time-consuming in the short run, the new publishing arrangements promise in the long run to increase greatly the journal's impact on the world of scholarship. This year has also been difficult because a key staff member in our previous publishing arrangements failed us. In 2005 we had 499 member/subscribers (406 domestic and 93 foreign). The bank balance is $4008.Vincent Colapietro delivered for Mark Migotti a preliminary version of the following financial report :2005 income was $1,713.05 ($1,497 in membership dues and $216.05 in interest). 2005 expenditures were c. $1,987.40: ($500 for the essay contest prize, $550 for travel subvention and dinner for the contest winner; 674.40 for mailings; $128.40 for web-site fees; $75 dues to the Logic and Methodology section of the International Society for the Philosophy of Science, and $60.00 for a subsidized membership for CISPEC).As of December 31, 2005, the Society's assets were: $10,625.92, a decrease of $.274... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Martin Heidegger and OntologyEmmanuel Levinas (bio)The prestige of Martin Heidegger 1 and the influence of his thought on German philosophy marks both a new phase and one of the high points of the phenomenological movement. Caught unawares, the traditional establishment is obliged to clarify its position on this new teaching which casts a spell over youth and which, overstepping the bounds of permissibility, is already in vogue. For once, (...) Fame has picked one who deserves it and, for that matter, one who is still living. Anyone who has studied philosophy cannot, when confronted by Heidegger’s work, fail to recognize how the originality and force of his achievements, stemming from genius, are combined with an attentive, painstaking, and close working-out of the argument—with that craftsmanship of the patient artisan in which phenomenologists take such pride. In this study, it is important for us to understand, above all, the true intentions of our author, to illuminate what he thinks really needs to be said, and to surmise what is most critical for him.To get to the heart of Heidegger’s system, it seems fitting to begin with a problem that is generally familiar. We choose the problem of knowledge, a deeper understanding of which takes us to the very threshold of Heidegger’s thought. For this problem, central to modern philosophy, is one of the main obstacles of modern philosophy that Heidegger wishes to surmount. Neo-Kantianism, which takes knowledge as the philosophical problem of the first rank, is the movement against which Heidegger rebels with all his strength. We have, thus, every chance of gaining access to his thought by the main door, so to speak. Once inside the system we will try to trace its outlines, 2 reserving, for a second part of our work, the determination of Heidegger’s place in the history of ideas, especially in the phenomenological movement, as well as of his relations with the philosopher to whom he owes so much—Edmund Husserl. 31In its most general form, the problem of the theory of knowledge has a critical significance. It consists in delineating a domain where knowledge can be certain and in determining the criteria for the legitimate scope of knowledge. But this problem, as normal and as simple as it may appear, has deeper roots. That knowledge should need a criterion at all presupposes that truth is not identical to all that is known and that the course [End Page 11] of things can fail to correspond with the course of thought. “How does knowledge correspond to being?” is a more profound formulation of the problem of knowledge.But we are not going to touch anymore on the primordial phenomenon that generates the problem. The problem of correspondence between thing and thought presupposes a free activity of thought and its isolation in relation to the object. It is precisely this presupposition which renders their harmony and even their contact problematic. “How does the subject take leave of itself to attain the object?” is what the problem of knowledge, in the last analysis, boils down to. Its true source is thus the concept of “subject” as elaborated by modern philosophy. The cogito presided over the subject’s birth. The cogito was the affirmation of the privileged nature of the subject’s immanent sphere, of its unique place in existence; hence, the cogito was the specificity of the subject’s connection to the rest of reality, the sui generis nature which opens up the passage from immanence to transcendence, the passage from ideas contained in the thinking substance to 4 their “formal existence.”The concept of the subject, understood as a substance having a specific position in the entire domain of being, presents us with difficulties of two kinds. First, how do we understand this leave-taking from the self which the thinking substance brings about and which displays an entirely original aspect? Indeed, we could say that thought, in reaching out toward objects, does not actually take leave of itself, since its objects—considered as ideas and contents of thought—are, in a certain sense, already within it. In order to make sense of this paradox, Descartes... (shrink)

Automatic screening tools such as plagiarism scanners play an increasing role in journals’ efforts to detect and prevent violations of research integrity. More than just neutral technological means, these tools constitute normatively charged instruments for governance. Employing the analytical concept of the digital imaginary, this contribution investigates the normative concepts that play a role in journals’ use of automatic screening. Using survey data of journal editors, as well as guidance documents by academic publishers and the Committee of Publication Ethics, (...) it traces how editors normatively situate their (non-)use of automatic screening tools in two opposing imaginaries of academic publishing: One that portrays academic publishing as a small and safe community, and one that sees it as a vast and dangerous space. These imaginaries reflect the social and epistemic characteristics and publication cultures in different academic fields, and both entail different modes of control. Additionally, they are shaped by a focus on plagiarism screening as a specific form of automatic screening that critically hinges on the issue of size of the publishing space, which exemplifies the mutual constitution of a specific problem, an imaginary where this problem becomes meaningful, and the availability of a tool that targets this problem. (shrink)

Objective Semiotica is published in six annual issues, in two languages (English and French). From time to time, Special Issues, devoted to topics of particular interest, are assembled by Guest Editors. The publishers of Semiotica offer an annual prize, the Mouton d'Or, to the author of the best article each year. The article is selected by an independent international jury. Topics We welcome papers reporting results of research in all branches of semiotic studies. Article formats Research articles, in-depth reviews, guest (...) editorials, reports Mouton D’Or Winner 2022 "Semiotricité et corps en jeu", Parlebas, Pierre, 248, 9-35. The judges commented: "The Committee members made this decision based on many appreciations. First, the article contains a concise theory on semiotics of movement, synthesizing decades of research of the author. It opens an exciting framework for the contribution of many other authors. The theoretical grounds of semiotircity are built on the most classical semiotic approaches and represent a genuine development. Second, the article refreshes semiotics methodology in very original way, by engaging the applied semiotics for furtive and instantaneous activities analysis. Third, the article is pretty clear and well structured, written in very comprehensible French. The theoretical frame it opens is thorough and far reaching. Fourth, the semiotic theory of movement comes in a very special moment when the whole world is football, but it covers also many other areas of applicability which reflect major trends such as the general gamification of life thanks to new media and digital technologies. It is crucial for semiotic theory to open its theoretic scope towards significant cultural trends and become more attractive for young researchers." Les membres du comité ont pris leur décision en fondant leur appréciation sur quatre éléments principaux. Premier élément : l'article, en peu de mots, en prenant appui sur des décennies de recherche de la part de l'auteur, déploie de manière précise les termes d'une sémiotique du mouvement. Les fondements théoriques de la sémiotricité sont construits sur des approches sémiotiques bien établies et représentent un véritable développement dans le domaine. En cela, le texte ouvre un cadre passionnant pour les contributions de nombreux autres chercheurs. Deuxièmement, l'article renouvelle la sémiotique appliquée de manière très originale, l'engageant dans une approche efficace des actions instantanées et furtives; la méthodologie sémiotique en général en tire donc aussi profit. Troisième point, en plus d'être profond, avec un cadre théorique d'ampleur et de grande portée, l'article est particulièrement bien structuré et écrit dans un français très compréhensible, ce qui est un véritable gain pour sa diffusion. Enfin, quatrièmement, s'il est indéniable que le texte pourrait bénéficier d'une visibilité complémentaire due à la ferveur liée au contexte récent de la coupe du monde de football au Qatar, il couvre surtout de nombreux autres domaines d'applicabilité qui reflètent des tendances majeures telles que la gamification générale de la vie, portée par les nouveaux médias et les technologies numériques. L'on y voit une belle opportunité pour la théorie sémiotique d'ouvrir son champ à la faveur de tendances culturelles significatives; ceci est une garantie pour continuer à attirer de nouvelles générations de chercheurs. (shrink)

As an accompaniment to the translation into English of Louis Althusser's 'Letter to the Central Committee of the PCF, March 18th, 1966', this note provides the historical and theoretical context necessary to understand Althusser's 'anti-humanist' interventions into French Communist Party policy decisions during the mid-1960s. Because nowhere else in Althusser's published writings do we see as clearly the political stakes involved in his philosophical project, nor the way in which this project evolved from a 'theoreticist' pursuit into a more (...) practical one, the note also argues that the letter is of importance to Althusser scholars, to historians of Marxist thought, and to those interested in the relevance of Althusser's work to contemporary Marxist philosophy. (shrink)

Although more women continue to enter the medical profession, disparities between the sexes in academic medicine persist. This “gender gap” has implications for academic advancement. In 2006, Jagsi and colleagues reported that, although the proportion of women among first and last authors in the United States had significantly increased since 1970, women still represented a minority of the authors of original research and guest editorials in six prominent medical journals.1 In a related 2008 study, Jagsi and colleagues found a substantial (...) increase in women’s representation on editorial boards and as editors-in-chief of several prominent journals.2 We collected more recent data about the gender distribution of authors, members of editorial boards, and peer reviewers for prominent medical journals. Using data from 2010-2011, we determined the proportion of women who were authors of original research or guest editorials, members of editorial boards, or reviewers at six major general medical journals: the Annals of Internal Medicine (Ann Intern Med), the British Medical Journal (BMJ), JAMA, JAMA Internal Medicine, the Lancet, and the New England Journal of Medicine (NEJM). (shrink)

The Boxdot Conjecture is shown to hold for a novel class of modal systems. Each system in this class is K plus an instance of a natural generalization of the McKinsey axiom. [Note from the editors: This paper was accepted for publication in 2011. It should have been published in 2014. The lateness of the appearance of the article is due entirely to an editorial oversight.].

Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group (...) devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees. (shrink)

This is the first volume in the Vienna Circle collection. The editorial committee plans to publish a series of about thirty volumes between 1973 and 1980. This gigantic task should render immense service to both historians and contemporary philosophers. The basic aim is to present in English anthologies of "the most important work of single members, which should contain besides a detailed essay on the man a complete bibliography of his work." The present large anthology of the writings (...) of Neurath presents a valuable collection of memories, in lieu of a biographical essay, revealing Neurath’s manysided interests and activities. Of more strictly philosophical interest are the short essays that deal with the history of optics, the problem of pleasure maximum, the scientific conception of the world; and a long selection from the book Empirical Sociology: The Scientific Content of History and Political Economy. (shrink)

This paper focuses on the REC and its political context to clarify the process of ethical review. The examples initially considered are taken from a Research Ethics Review editorial to develop the social explanation of the membership and function of a research ethics committee. It is suggested that the management and administration of medical matters are not always best understood solely in medical terms. The conclusion of the paper is that the larger political relationships determine the membership and (...) function of the research ethics committee. The REC is defined as the political mechanism for formally socializing medical research and its lay members as similarly socializing the REC. (shrink)

My paper will explore boundaries and rights, the public and the private, as to the enforcement of religious legal rules in societies self-consciously founded on Islamic law. I employ as my case-study legal and social controversies aroused by the Saudi Hay’at al-amr bi-al-ma`ruf wa-al-nahy `an al-munkar, the government agency charged with “ordering the good and forbidding the evil.” The paper will first lay out some of the laws fixing the powers of the Hay’at, including various statutes issued by the king (...) but, of equal or greater importance, the received medieval fiqh rules governing the muhtasib . Focus shall be on an issue much debated in the classical law and also a long-time bone of contention in Saudi society, namely the legal limits on the powers of the Hay’at to investigate and punish immoral acts occurring in private. Limits on such powers stem from two sources, both in the law and in social understandings of that law. One source, the more prominent in public debate, concerns revelatory and fiqh and related social norms against spying or prying into people’s behavior and against undue attempts to expose people’s sins. Notably, however, this restriction affects only enforcement. The pervasiveness of laws considered to arise from the relationship of the individual to God still stands. A solitary immoral act performed in privacy can still be a sin and a crime, and punishable if it is somehow legitimately known and proved . The second source of restrictions is more far-reaching, going beyond issues of investigation and proof. As held by the majority of scholars, the Hay’at may not compel or forbid any actions for which the religious-legal ruling is under classical law a matter of legitimate difference of scholarly opinion; or inversely, the Hay’at may compel or forbid only those actions as to which there is a divine command known to a certainty either from a revealed text or from the consensus of scholars. A commonly noted abuse by the Hay’at in Saudi Arabia has been to attempt to enforce rules lacking requisite certainty, such as requiring veiling of the face. Rules known to a certainty have a pervasive role in Islamic constitutional theory. In principle, such rules must be enforced, regardless of whether they concern matters other societies may consider individual or private, such as changing one’s religion. Rules lacking that high degree of certainty cannot – without separate justification on grounds other than religious text – define sins or crimes or be enforced as general rules by the state. Though seemingly scholastic and philosophical, this restriction is potentially crucial in defining a realm of individual autonomy in religious matters and shaping the boundary between public and private in societies self-consciously founded in Islamic law. It is important to examine to what extent the restriction is reflected in legal and social practice in such societies. (shrink)

: In June 2002, the Advisory Committee on Immunization Practices (ACIP) approved draft recommendations concerning preparation for potential biological terror attacks that utilize the smallpox virus. ACIP recommends against both mandatory and voluntary vaccination of the general public. The present paper examines the moral and political considerations both for and against each of the general public vaccination options considered by the ACIP in the context of the state's authority over vaccination for the purposes of protecting public health. (...) Although it is clear that compulsory mass vaccination is not justified at this time, the issues surrounding voluntary vaccination are more complex. Should smallpox vaccination prior to an outbreak be made available to the general public? The paper concludes that the vaccine should not be made available at this time. This conclusion, however, is based upon contingent features of current circumstances, which would change once an outbreak occurred. In the event of a terror-related outbreak of smallpox, the general public's access to voluntary vaccination would become justified, even in areas beyond where the outbreak has occurred. (shrink)

Zur patientenorientierten Behandlung bei nichteinwilligungsfähigen Patienten werden aktuell der Einbezug oder auch die Entscheidung durch ein Ethikkonsil oder klinisches Ethikkomitee (KEK) gefordert. Damit die Entscheidung des Entscheidungsträgers durch das KEK unterstützt werden kann, müssen Zuständigkeiten, Besetzung und Arbeitsweise des Gremiums klar umschrieben sein.

The role of the Research Ethics Committee (REC) in the design, conduct and dissemination of scientific research is still evolving and many important questions remain unanswered. Hence, the aim of this paper is to address some of the uncertainty that exists around the role and responsibilities of RECs and to discuss some of the controversy that exists over the criteria that RECs should follow when evaluating a research proposal. The discussion is organised around five of the major roles currently (...) performed by RECs when assessing proposals in the biomedical sciences. It will be shown that these five roles need to be critically evaluated and reassessed. The five roles addressed are: assessing the legitimacy and validity of the informed consent process, second, conducting a comprehensive risk/benefit analysis, third, assessing the validity of a research proposal, fourth, ensuring that researchers observe the social norms, values, customs, traditions and laws that prevail in the community or jurisdiction in which the research will be conducted and finally, monitoring the research project as it unfolds and providing an ongoing advisory and consultancy service to both new and experienced researchers. In reassessing the role of the REC, this paper concludes with a set of general recommendations for RECs. These provide some guidance on the minimum criteria that should be followed when RECs evaluate proposals. These guidelines will be beneficial for new and experienced members of REC, and will help to make the process a more objective, efficient and standardised process. The guidelines will also be beneficial for researchers in the biomedical sciences who are preparing proposals for ethical review. (shrink)

Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, Ovid (...) MEDLINE, Scopus, Philosopher’s Index, Embase and Web of Science), following PRISMA guidelines. We included only articles specifically addressing CECs and providing any form of CECs performance assessment. Twenty-nine articles were included. Ethics consultation was the most evaluated of CECs’ functions. We did not find standardized tools for measuring CECs’ efficacy, but 33% of studies considered “user satisfaction” as an indicator, with 94% of them reporting an average positive perception of CECs’ impact. Changes in patient treatment and a decrease of moral distress in health personnel were reported as additional outcomes of ethics consultation. The highly diverse ways by which CECs carry out their activities make CECs’ evaluation difficult. The adoption of shared criteria would be desirable to provide a reliable answer to the question about their effectiveness. Nonetheless, in general both users and providers consider CECs as helpful, relevant to their work, able to improve the quality of care. Their main function is ethics consultation, while less attention seems to be devoted to bioethics education and policy formation. (shrink)

This is the editorial for a special volume of JETAI, featuring papers by Omohundro, Armstrong/Sotala/O’Heigeartaigh, T Goertzel, Brundage, Yampolskiy, B. Goertzel, Potapov/Rodinov, Kornai and Sandberg. - If the general intelligence of artificial systems were to surpass that of humans significantly, this would constitute a significant risk for humanity – so even if we estimate the probability of this event to be fairly low, it is necessary to think about it now. We need to estimate what progress we can (...) expect, what the impact of superintelligent machines might be, how we might design safe and controllable systems, and whether there are directions of research that should best be avoided or strengthened. (shrink)

Between 1820 and 1850, the Dutch government sent several scientists to the Netherlands Indies as part of the Natuurkundige Commissie (Natural History Committee). One of these was naturalist Eltio Alegondus Forsten (1811–1843), who was sent on a collecting mission to Celebes (Sulawesi). This paper explores the ways in which Forsten was in a relationship of mutual interdependence with four spheres of influence, two in the Netherlands (those of the Dutch government and the natural history museum in Leiden) and two (...) in the Dutch East Indies (those of the governor-general and the local population of Forsten's collecting grounds). These four entities served as focal points for Forsten's practice, and tried to use his mission for their own purposes. At the same time, Forsten negotiated their demands deftly and turned them to his own advantage in order to serve his own future career. Throughout, I draw parallels with the experiences of various other members of the Natural History Committee. I ultimately propose that this case study of Forsten provides a glimpse of a possible pattern for the relationship between government-sponsored science and empire in the Dutch East Indies in the first half of the 19th century. (shrink)

In 2009, the UK House of Commons Science and Technology Committee conducted an ‘evidence check’ on homeopathy to evaluate evidence for its effectiveness. In common with the wider literature critical of homeopathy, the STC report seems to endorse many of the strong claims that are made about its implausibility. In contrast with the critical literature, however, the STC report explicitly does not place any weight on implausibility in its evaluation. I use the contrasting positions of the STC and the (...) wider critical literature to examine the ‘implausibility arguments’ against homeopathy and the place of such arguments within evidence-based medicine. I argue that the STC report undervalues its strong claims about the mechanistic plausibility of homeopathy because it relies on a misunderstanding about the role of mechanistic evidence within EBM. This is not a conclusion for a revision of the role mechanistic evidence plays within EBM, however. It is a conclusion about the inconsistency of the STC report’s position towards implausibility arguments, given the evidential claims they endorse and the atypical situation that homeopathy presents. It provides a further example of the general point that mechanistic reasoning should not be seen as providing categorically lower quality evidence. (shrink)

Governments have used several mechanisms to deal with intractable policy conflicts about issues in bioethics. One mechanism is the installment of an ethics committee and another one is the organization of public debates. Often, ethics committees have an implicit or explicit role in the stimulation of such public debate. However, this role is not self-evident and we therefore analyse the relation between committees and public debate. What should the function of biotechnology ethics committees be, how does this relate to (...) their composition, and to what extent are these functions met in practice? To this end, we have examined the three national committees of the Netherlands, Switzerland, and Australia in the field of animal and plant biotechnology. We argue that there is often a mismatchbetween the goals one wants to reach by stimulating public debate and the way this has been given shape, partly through ethics committees. In fact, installing (biotechnology) ethics committees is to a certain extent a premature move that contains rather than stimulates public debate. (shrink)

Much has been written about the role of hospital ethics committees. Ethics committees may have begun in Seattle in the early 1960s, but they were reified in. New Jersey by the Quinlan Court in the 1970s and thrived in the national bioethics movement of the 1980s.In this flurry of ethics activity, several new forms of ethics committees have evolved. New forms of ethics committees include patient care-oriented ethics committees. Many ethicists are familiar with mission-oriented ethics committees. Such committees have taken (...) on new roles, and Include PROs, IPCs, and HREAPs. In general, these committees are regulatory in nature and may often rely on rules and regulations to assess patient cases, research protocols, and health professional practices. (shrink)

If one accepts the social hierarchy that this taste structure masks, it is easy to accept the validity of the particular criteria which serve as the working test of excellence. In fact, the high value placed on rationality, complexity, irony, reflexivity, linguistic innovation, and the “disinterested” contemplation of the well-wrought artifact makes sense within cultural institutions devoted to the improvement of the individuality, autonomy, and productive competence of the already privileged individuals who come to them for instruction and advice.8 Appreciation (...) for the technical fine points of aesthetic achievement is also understandable among people whose daily work centers on the business of discrimination. But it is worth keeping in mind that the critical dismissal of literary works and institutions that do not embody these values as failures is an exercise of power which rules out the possibility of recognizing that such works and institutions might be valuable to others because they perform functions more in keeping with their own somewhat different social position, its material constraints, and ideological concerns. The essay critical dismissal of the Club and other “popularizers” is an act of exclusion that banishes those who might mount even the most minimal of challenges to the culture and role of the contemporary intellectual by proclaiming their own right to create, use, and value books for different purposes.My preoccupation with the Book-of-the-Month Club arises, then, out of a prior interest in the way books are variously written, produced, marketed, read, and evaluated in contemporary American culture. My subjects might best be described as ways of writing rather than Literature, ways of reading rather than texts.9 I have begun to examine the Club’s editorial operation with the intention of eventually comparing the manner, purpose, and substance of the editors’ choice of books with the choices of actual Book-of-the-Month Club members. Such a comparison seems potentially interesting for a variety of reasons. 8. For a discussion of the connections between the social position and role of literary academics and the values they promote through the process of canonization, see Jane Tompkins, Sensational Designs: The Cultural Work of American Fiction, 1790-1860 , esp. pp. 186-201.9. See, for instance, my earlier effort to specify how a group of women actually read and evaluate individual books in the much-maligned romance genre, Reading the Romance: Women, Patriarchy, and Popular Culture . I am indebted to Mary Pratt’s discussion of the concept of “literariness” and the way it disciplines ideologically this particular way of describing my own interests. Janice Radway is an associate professor of American civilization at the University of Pennsylvania. She is the author of Reading the Romance: Women, Patriarchy, and Popular Literature and is a former editor of American Quarterly. This article is part of a larger study, the working title of which is “The Book-of-the-Month Club and the General Reader: The Transformation of Literary Production in the Twentieth Century.”. (shrink)

This paper explores an increasingly prevalent element of board-level commitment to sustainability. We propose a theoretical framework under which the existence and associated actions of board-level sustainability committees are motivated by shared value creation, where the interests of a diverse group of stakeholders are satisfied and sufficient profit is achieved. Using hand-collected data, we find that sustainability committees are heterogeneous in focus and vary in their effectiveness. Specifically, we disaggregate the sustainability committee construct based on stakeholder group focus and (...) find that associations between sustainability committees and performance outcomes are stronger when committees focused on a specific stakeholder group are paired with relevant performance outcomes. We generally find that sustainability committees are effective at impacting relevant strengths, but do not mitigate relevant concerns. These results are consistent with the shared value framework, where committees both generate value by pursuing sustainability-related opportunities and protect value by monitoring, but not necessarily mitigating sustainability-related risks. Univariate tests suggest that effective committees are also larger, more independent, and meet more frequently. Finally, we propose a new method to classify industries based on their sensitivity to certain stakeholder groups and find that the effectiveness of committees focused on specific stakeholders is more pronounced in industries that are sensitive to these stakeholders. (shrink)

Context The conduct of medical research led by Northern countries in developing countries raises ethical questions. The assessment of research protocols has to be twofold, with a first reading in the country of origin and a second one in the country where the research takes place. This reading should benefit from an independent local ethical review of protocols. Consequently, ethics committees for medical research are evolving in Africa. Objective To investigate the process of establishing ethics committees and their independence. Method (...) Descriptive study of 25 African countries and two North American countries. Data were recorded by questionnaire and interviews. Two visits of ethics committee meetings were conducted on the ground: over a period of 3 months in Kigali (Rwanda) and 2 months in Washington DC (USA). Results 22 countries participated in this study, 20 from Africa and two from North America. The response rate was 80%. 75% of local African committees developed into national ethics committees. During the last 5 years, these national committees have grown on a structural level. The circumstances of creation and the general context of underdevelopment remain the major challenges in Africa. Their independence could not be ensured without continuous training and efficient funding mechanisms. Institutional ethics committees are well established in USA and in Canada, whereas ethics committees in North America are weakened by the institutional affiliation of their members. Conclusion The process of establishing ethics committees could affect their functioning and compromise their independence in some African countries and in North America. (shrink)

Background: Editorial peer review is universally used but little studied. We examined the relationship between external reviewers' recommendations and the editorial outcome of manuscripts undergoing external peer-review at the Journal of General Internal Medicine. Methodology/Principal Findings: We examined reviewer recommendations and editors' decisions at JGIM between 2004 and 2008. For manuscripts undergoing peer review, we calculated chance-corrected agreement among reviewers on recommendations to reject versus accept or revise. Using mixed effects logistic regression models, we estimated intra-class correlation (...) coefficients at the reviewer and manuscript level. Finally, we examined the probability of rejection in relation to reviewer agreement and disagreement. The 2264 manuscripts sent for external review during the study period received 5881 reviews provided by 2916 reviewers; 28% of reviews recommended rejection. Chance corrected agreement on rejection among reviewers was 0.11. In mixed effects models adjusting for study year and manuscript type, the reviewer-level ICC was 0.23 and the manuscript-level ICC was 0.17. The editors' overall rejection rate was 48%: 88% when all reviewers for a manuscript agreed on rejection and 20% when all reviewers agreed that the manuscript should not be rejected. Conclusions/Significance: Reviewers at JGIM agreed on recommendations to reject vs. accept/revise at levels barely beyond chance, yet editors placed considerable weight on reviewers' recommendations. Efforts are needed to improve the reliability of the peer-review process while helping editors understand the limitations of reviewers' recommendations. © 2010 Kravitz et al. (shrink)

The Report of the Ad Hoc Adivisory Group on the Operation of NHS Research Ethics Committees has resulted in a strange mixture of the timid, the revolutionary, and the bizarre.The Report of the Ad Hoc Advisory Group on the Operation of NHS Research Ethics Committees is a curious document.1 The remit of the review was focused on the workings and effectiveness of NHS research ethics committees and the multicentre committees ). The Group was primarily set up in response to a (...) series of complaints from medical researchers about the new research governance regime in the UK as a result of the Clinical Trials Directive2 and the Governance Arrangements for NHS Research Ethics Committees.3 The opportunity was also taken to consider the role of research ethics committees in a wider context, and take account of recent developments in relation to the ethics review of social care research,4 student projects,5 as well as recent legislation such as the Human Tissue Act,6 and the Mental Capacity Act.7 However, the resulting report is a strange mixture of the timid, the revolutionary, and the bizarre.A good example of the report’s timidity is its reluctance to propose fundamental change to the process of review or seriously limit the type of research that requires REC review. To its credit AHAG does suggest that some research ‘especially surveys and many studies on NHS staff, could normally be conducted safely without a requirement for REC review’ .1 This is, of course, to be welcomed. However, the report ultimately seems dismissive of the general complaint from researchers that the current process is inappropriately uniform. For example, in section 3.2, it is argued that the ‘common perception that the NHS REC system is dominated …. (shrink)

Definition of the problemFrom an ethical point of view we analyse the ruling of the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G‑BA) of September 2019 to revise the guidelines about the coverage of noninvasive prenatal tests (NIPT) by mandatory health insurance, in order to include them under specified conditions. The decision contains four essential elements: a definition of the aim of NIPT testing (to avoid invasive testing), a criterion of access (test must be “necessary” for the pregnant woman to (...) tackle her individual situation), statements about the process of decision-making (after counselling by a physician and case by case) and a normative contextualization (termination of pregnancy under § 218 a German penal law) which is to be found in its explanations. There are tensions in the proposed model that oscillate about two axes: (1) The suffering that results from a possible birth of a child with trisomy or from not knowing about the genetic condition of the fetus can ultimately only be evaluated subjectively, from the perspective of the pregnant woman. (2) The meaning of an individual decision in the case-by-case model remains unclear because when judging about individual cases general points of view also need to be considered. However, we argue that the model of the G‑BA could be a sociopolitically and ultimately also ethically defensible pragmatic solution, exactly because of its paradoxes and its inherent flexibility. (shrink)

In 2002, I wrote an editorial in this Journal arguing that it was time to review the structure and function of ethics committees in the USA, Australia and the UK.1 This followed the deaths of Ellen Roche and Jesse Gelsinger, which were at least in significant part due to the poor functioning of research ethics committees in the USA.2 In the case of Ellen Roche, it was the failure to require a systematic review of the existing literature which led (...) to her death. Iain Chalmers and I had previously documented in 1996 the failure of ethics committees to require systematic review.3 In 1998, at the time of revising the previous guidelines and forming the first Australian National Statement on Research Ethics, I made a public submission to the Australian Health Ethics Committee arguing that the new guidelines for RECs should include a person with skills in conducting systematic reviews of the literature and that the requirement to have a religious representative on the committee be replaced with the requirement to have an ethicist. Neither of these changes was made. I argued, ‘It is time to ask whether institutional RECs should be abandoned in favour of expert committees that cover many institutions—suprainstitutional specialist committees. Supraregional specialist ethics committees could specialise—for example, in genetic research, cancer clinical trials, dermatology, respiratory physiology and each of the specialist areas of medical research. An example of such a committee is provided by the Thoracic Society of Australia and New Zealand research ethics committee, which reviews multicentre trials of respiratory drugs’.4 Around that time, I was involved ‘at the coal face’ as Chair of the Department of Human Services Ethics Committee in Victoria. In a public presentation, I arguedThere are two philosophical views of what ethics review is. On the …. (shrink)

BACKGROUND: It can be argued that the ethical conduct of research involves achieving a balance between the rights and needs of three parties-potential research participants, society, and researchers. Local Research Ethics Committees (LRECs) have a number of roles and functions in the research enterprise, but there have been some indications that LREC members, researchers and the public can have different views about these responsibilities. Any such differences are potential sources of disagreement and misunderstanding. OBJECTIVES: To compare the views of LREC (...) members, researchers and the public towards the roles and functions of LRECs. DESIGN: A questionnaire that contained items concerned with a variety of such roles was distributed to general practice patients (as proxies for potential research participants), researchers and LREC members. FINDINGS: While general practice patients believed that the main function of LRECs is to ensure that research participants come to no harm, LREC members were more concerned with the protection of participants' rights. There was also some disagreement between members and researchers with regard to the consideration of proposals on the grounds of scientific merit. CONCLUSIONS: Local Research Ethics Committee members need to be aware of potential differences in views, that they ought to make their priorities clear, and that membership of LRECs ought to reflect the views of both researchers and potential research participants. (shrink)

Clinical ethics consultations (CECs) play an important role in resolving ethical issues in clinical practice worldwide. The government has encouraged the development of CECs in China to address the ethical challenges arising in prenatal diagnosis. So far, the current state and challenges facing CEC remain understudied. This study aimed to explore the perspectives of employees on ethics committees for prenatal diagnosis in 13 medical institutions in Hunan Province, China. Twenty-eight employees participated in interviews. Our qualitative approach employed content analysis to (...) identify major themes in interviewees’ responses, which covered the composition and vision of their prenatal diagnosis ethics committee, as well as the challenges they faced. The results show that CEC in China is in an exploratory stage, with models for CEC composition, and workflow varying significantly. Therefore, we propose the future direction of efforts to improve CECs, including improving CEC working mechanisms and operating procedures, strengthening ethical training for healthcare workers and ethics committee employees, and developing more specific ethical guidance based on the accumulated experiences of ethics committee employees in the early development of CEC for prenatal diagnosis. (shrink)

This paper investigates the key drivers behind the origins of value-for-money (VFM) audit in Canada and the aims, intents, and logics ascribed by the original proponents. Drawing on insights from governmentality and New Public Management, the paper utilizes analysis methods adapted from case study research to review a wide range of primary documentation (e.g., Hansards from the Public Accounts Committee, House of Commons debates, the so-called Wilson report and the FMCS study) and secondary documentation (newspaper articles, Office of the (...) Auditor General internal publications, journal articles). Major findings indicate a rise of a management consulting culture within the Auditor General’s office following the appointment of James Johnson Macdonell. VFM legislation effectively operationalized practices drawn from management consulting expertise by invitation of the consultant. It was offered as an answer to the growing scope and size of government, which had become problematized by the Auditor General in terms of parliament losing control over the public purse. The Auditor General’s invocation of financial crisis led to a substantial broadening of mandate and increase in resources for that office. (shrink)

Background: Authors are required to describe in their manuscripts ethical approval from an appropriate committee and how consent was obtained from participants when research involves human participants.Objective: To assess the reporting of these protections for several study designs in general medical journals.Design: A consecutive series of research papers published in the Annals of Internal Medicine, BMJ, JAMA, Lancet and The New England Journal of Medicine between February and May 2003 were reviewed for the reporting of ethical approval and (...) patient consent. Ethical approval, name of approving committee, type of consent, data source and whether the study used data collected as part of a study reported elsewhere were recorded. Differences in failure to report approval and consent by study design, journal and vulnerable study population were evaluated using multivariable logistic regression.Results: Ethical approval and consent were not mentioned in 31% and 47% of manuscripts, respectively. 88 papers failed to report both approval and consent. Failure to mention ethical approval or consent was significantly more likely in all study designs than in randomised controlled trials . Failure to mention approval was most common in the BMJ and was significantly more likely than in The New England Journal of Medicine. Failure to mention consent was most common in the BMJ and was significantly more likely than in all other journals. No significant differences in approval or consent were found when comparing studies of vulnerable and non-vulnerable participants.Conclusion: The reporting of ethical approval and consent in RCTs has improved, but journals are less good at reporting this information for other study designs. Journals should publish this information for all research on human participants. (shrink)

Hospital ethics committees (HECs) are expected to play extremely broad and pivotal roles such as case consultation, education of staffs on healthcare ethics, and institutional policy formation. Despite the growing importance of HECs, there are no standards for setup and operation of HECs, and composition and activities of HECs at each institution are rarely disclosed in Japan. In addition, there is also a lack of information sharing and collaboration among HECs. Therefore, the authors established the Consortium of Hospital Ethics Committees (...) (CHEC) in October 2020, which has been regularly hosting a couple of core activities. One is the Healthcare Ethics Forum, held monthly online for CHEC members to freely discuss HECs and healthcare ethics consultation. The other is the Collaboration Conference of Hospital Ethics Committees, intended to provide a place for HEC members and administrative officers from across Japan to exchange information of their HECs, learn from each other, and cooperate to operate HECs appropriately. In this paper, the authors introduced CHEC as well as reported the results of a questionnaire survey conducted at the first conference among participating facilities, suggesting the diverse structures and activities of HECs in Japan. (shrink)

The violation of editorial independence by the CMA seriously damaged trust in CMAJ and raises questions whether the CMA can operate a truly independent journalOn February 20, 2006, John Hoey and Anne Marie Todkill, the two most senior editors of the Canadian Medical Association Journal were fired by the journal’s publisher, Graham Morris. At first, CMA spokespersons said that the firing had been planned for some time based on a desire to “refresh” the journal. Later they refused to offer (...) any explanation, and weeks later they declared that there had been “irreconcilable differences,” without specifying anything more. After the journal’s editorial board tried fruitlessly to convince the Canadian Medical Association to reinstate the dismissed editors, I resigned from the editorial board. I had been a member since 1999. My letter of resignation to the CMA’s president made these points:" “By interfering with the editorial autonomy of two outstanding editors and firing them without explanation, you have provoked a scandal that will be long remembered as a blot on Canadian Medicine. … Despite the acknowledged success of the CMAJ, you gave no cause for the editors’ dismissals. … You caused the editors to be fired without consultation with major members of the Journal Oversight Committee. … In your public comments, you were even disingenuous about whether the editors were fired. … In answering to the issue of the editors’ departure, you have hidden behind a veil of bureaucratic legalisms, and by arguing that the Editorial Board knows only “one side,” you have left the impression that the editors have done something nefarious. Thereby, you have besmirched the good names and reputations of the editors. … You have mounted a PR campaign to “spin” public opinion at the expense of honest, respectable and hard working … ". (shrink)

Hospital ethics committees must be knowledgeable if they are to perform consultations, advise administrators on policy, or offer educational programs. Because the membership of the committee is interdisciplinary, with most drawn from the healthcare professions, the individuals who join cannot be expected to bring knowledge of bioethies with them. Therefore, a new committee must spend time developing expertise before it can appropriately serve the hospital community. Although the need for committee self-education is generally recognized, it is seldom (...) discussed in any detail. When discussed at all, expertise in bioethies is usually described as composed of a familiarity with an identifiable body of knowledge and mastery over techniques of moral reasoning. It is assumed that a committee can develop this expertise early in its life through a short course of study. (shrink)