This article investigates a high-profile and ongoing dilemma for healthcare professionals (HCPs), namely whether the existence of a (legal) duty of care to genetic relatives of a patient is a help or a hindrance in deciding what to do in cases where a patient’s genetic information may have relevance to the health of the patient’s family members. The English caseABC v St George’s Healthcare NHS Trust and othersconsidered if a duty of confidentiality owed to the patient and a putative duty (...) of care to the patient’s close relatives could coexist in this context. This article examines whether embracing the concept of coexisting duties could enable HCPs to respect duties in line with their clinical judgement, thereby providing legal support and clarity to professionals to allow them to provide the best possible genetics service to both the patient and their family. We argue that these dual duties, framed as a novel, composite duty to consider the interests of genetic relatives, could allow HCPs to exercise and act on their professional judgements about the relative value of information to family members, without fears of liability for negligence or breach of confidence. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

Regrettably, in the original version of this article the name of one of the authors was spelt incorrectly. "Li Yan Hsu" should be "Li Yang Hsu".

Using the British mental health services as a case study, this book critically reviews the various social, political and intellectual developments which have shaped psychiatric practice and the delivery of mental health services.

(2013). The “Difficult Patient” Conundrum in Sickle Cell Disease in Kenya: Complex Sociopolitical Problems Need Wide Multidimensional Solutions. The American Journal of Bioethics: Vol. 13, No. 4, pp. 20-22. doi: 10.1080/15265161.2013.767960.

Abstract:This article repositions Thomas Arnold as a major nineteenth-century historian through an analysis of his most important work, the History of Rome (1838–42). While scholars have focused primarily on Arnold's role as headmaster of Rugby School and Liberal Anglican theologian, I examine his historical contribution in the context of the Romantic movement. Building on the work of B. G. Niebuhr and Giambattista Vico, Arnold interpreted the contest between the patricians and plebeians at Rome as emblematic of a universal class struggle, (...) in which failure to find a compromise between the rich and the poor would inevitably lead to disaster. (shrink)

BackgroundThe complexity of decision-making in the paediatric context is well recognised. In the majority of cases, parents and healthcare professionals work together to decide which treatments the paediatric patient should receive. On occasions, however, parental wishes conflict with what clinicians think is best for the paediatric patient. Where persistent disagreement between clinicians and parents exists, clinicians must ascertain if they have a moral, professional, and legal obligation to overrule the parents' decision and implement their preferred option.PurposeFew decision-making frameworks to assist (...) in addressing the ethical issues that arise in clinical decision-making relate specifically to the paediatric context. Diekema's Harm Threshold Framework and the Zone of Parental Discretion Framework assist in determining whether parental decisions should or should not be overridden. This paper examines the similarities and differences between these frameworks.MethodsThe frameworks are analysed i... (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

El presente trabajo nació como una reflexión posterior a la traducción del libro de Stanley Cavell Contesting Tears: The Hollywood Melodrama of the Unknown Woman. La reflexión era necesaria habida cuenta de las dudas suscitadas por la traducción del título del libro. Para ser más exacto, la reflexión giraba en torno a las lágrimas que forman parte de la primera parte del título, las lágrimas vertidas por las mujeres desconocidas que protagonizan los melodramas analizados en el libro. En mi opinión, (...) llegar a entender la razón y la naturaleza de esas lágrimas es clave para comprender lo que Cavell nos viene contando desde hace cinco décadas. Por ello, lo que sigue intenta reunir mis propios comentarios sobre la obra de Cavell en general, con la justificación de la traducción final del título: Más allá de las lágrimas. (shrink)

Anthropology diffracted : originary humanicity -- Just figures?: forensic clairvoyance, mathematics, and the language question -- Enumerating language : "The unreasonable effectiveness of mathematics" -- Natural convers(at)ions : or, what if culture was really nature all along? -- (Con)founding "the human" : rethinking the incest taboo -- Culpability and the double-cross : Irigaray with Merleau-Ponty.

Do you ever wonder why some people just rub you the wrong way? Or why you automatically click with others? Or maybe you even ask yourself, "Who am I, really?" Wouldn't it be wonderful if you could understand why people are the way they are--and even better understand yourself? Now you can! And it's simple and fun! Based on the ancient Five Elements model from Chinese medicine, Dr. Vicki Matthews has developed a simple way to describe our five basic personality (...) types and the predictable ways in which they interact. Take your first step toward happier and more harmonious relationships in every area of your life--including a better relationship with yourself! The result of years of personal and professional experience, this invaluable book can improve every relationship you have and make your life better! -- Publisher. (shrink)

Much has been written over the last decade on the urgency of expanding the canon, although the imperialist overtones of such a movement have not always been registered. A great deal of attention has pooled at the borders of the canon, as we aim to erode or extend those borders, but crucial assumptions about the privileged status of the subject matter that we as critics choose, whatever that subject matter may be, canonical or extracanonical, have not been questioned with comparable (...) intensity. Although the hegemony of the subject and the concomitant transformation of the “other” into an object have been attacked theoretically from several different directions , we nevertheless lack a widespread practical, professional awareness of the extent to which the status of what we “criticize” and teach silently reproduces a subject/object economy of privilege. In the pages that follow, my contribution to the case against the sacralized status of art emerges out of the implicit dialogue that Paul Wunderlich initiates with James Joyce on the “subjects” of sexism, anti-Semitism, art, and politics, set against the background of the Holocaust. My target is neither Wunderlich nor Joyce—nor is it any of the groups that they might be said to represent—but the political implications of artistic privilege, a priveilege that criticism, even “resistant” criticism, may seek to redistribute but not to challenge. My aim is not to desecrate Joyce’s authority nor to objectify him as a stereotypical sexist or anti-Semite, but to deauthorize and rehumanize his monumental status by recontextualizing the grounds of his achievement, climbing down to . She is currently working on a book about the politics of representation. (shrink)

In this manuscript, I analyze Slavoj Žižek’ s debate with the Canadian clinical psychologist Jordan Peterson. The terms “Venus envy” and “academic inferiority complex” are used based on classical psychoanalytic jargon. Jordan Peterson and Slavoj Žižek are interpreted as the representatives of the opposing ends of our contemporary academic postmodern spectrum. Žižek demonstrates the unchained M arxist, and Peterson embodies the persona of the capitalist educator. T his article is a gateway to shed light on the decaying core of postmodern (...) ideology in contemporary academic discourse. (shrink)

In the hundred years since its publication, Wittgenstein’s Tractatus Logico-Philosophicus has become a contemporary classic with the peculiarity that it is surrounded by an aura of mystery: what is really Wittgenstein’s aim in writing the Tractatus, how are we to understand the last two propositions of the Tractatus that enjoin us to detach ourselves from the book itself and keep silent, can the Tractatus be anything other than a positivist and anti-metaphysical treatise, and so on? Here we will argue that (...) the answer to these questions must consider what the ethical meaning of the Tractatus might be and, closely related to that, what its importance is and that of the ineffable in general. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Philosopher’s Seduction: Hume and the Fair SexVicki J. SappFollowing the failed reception of his Treatise David Hume turned to writing essays and published these in various editions throughout his career. Among the first offerings were essays addressing “the female reader,” “the ladies,” or “the fair sex” in that current habit which Jonathan Swift labelled “fair-sexing it.” Hume’s Victorian editors T. H. Green and T. H. Grose classified and (...) commented upon these woman-appeal essays “apparently designed to attract the attention of ladies, and marked by the mannerisms of what was then a fashionable literature,” concluding that these “can hardly have been much to their writer’s taste, and... mingle strangely with a series of discussions on the British Constitution.” 1 Green and Grose refer to the fact that Hume gradually eliminated his woman-appeal essays from the editions; today, we find these “literary” texts safely removed from the “moral and political” frame and anthologized as “Essays Withdrawn and Unpublished” in the two modern editions of Hume’s essays. 2Following Hume’s apparent cue, the critical tradition has paid little heed to the woman-appeal essays except in those cases where kind neglect has given over to insult or factionalism. From the former category we find contemporary readers such as M. A. Box who in his rhetorical analysis of Hume’s opus echoes earlier judgments of these essays as frivolous, mercenary, essentially devoid of substantive or stylistic worth—and most certainly unphilosophical. In the latter case, scattered commentators from the 1970s and 1980s reflecting those decades’ gynocritical trend built cases for Hume’s “sexism” (primarily) or “feminism” (most notably the philosopher Annette Baier). And Jerome Christensen has attended to Hume’s female reader in his [End Page 1] elaborate theoretical play with Hume’s gender as a metaphor for his literary ambitions. 3What is curious is that each of the above readers has passed over the woman-appeal essays in favor of Hume’s “serious” writing (for example, Treatise, Book III, Part II, sect. xii, “Of Chastity and Modesty”) or his letters, even though the rejected woman-appeal essays are obviously rich sources for a study of Hume’s gender perspectives. It is true that in “Of Chastity and Modesty” Hume offers what is perhaps his best evidence of society’s conventional as opposed to metaphysical foundations, in his argument that the laws of chastity governing female education and behavior are certainly “notions... founded on the public interest,” that is, patriarchal property interest. In the woman-appeal essays Hume actually works out, by illustration, the gender-biased foundational intricacies of his social contract philosophy, especially the importance of education to the regulation of society: “As publick praise and blame encrease our esteem for justice; so private education and instruction contribute to the same effect.... For these reasons [parents] are induc’d to inculcate on their children, from the earliest infancy, the principles of probity, and teach them to regard the observance of these rules, by which society is maintain’d, as worthy and honourable, and their violation as base and infamous.” 4The rejected woman-appeal essays include titles that bespeak a focus on gender, education, and social formation (“Of Love and Marriage,” “Of Moral Prejudice”), as well as titles that appear more public or scholarly: “Of Essay Writing,” “Of the Study of History.” In spite of their topical neutrality or marginally “political” tone, these latter two I identify as Hume’s core woman-appeal essays. In them Hume brings the female reader into the spotlight, inviting her into a dialogue with the male philosopher-essayist; she is to share in a sort of Humean Utopia of gender-mixed educated, genteel company servicing the ends of true philosophy in the marriage of intellection and experience. As overt appeals to “women of Sense and Education” featuring some gestures towards gender equality, these essays, one suspects, were doomed to eventual rejection by both Hume and a subsequent critical tradition prone to the kneejerk devaluation of woman-appeal.I offer here evidence that the rejected essays do have “philosophical” merit as they take up or dramatize core ideas of Treatise philosophy. These essays also feature some... (shrink)

Recent state regulations require women, before undergoing abortions, to be subjected to unwanted and nonmedically necessary sonograms, often requiring an intrusive vaginal probe. Physicians, for their part, are forced to turn the viewing screens toward the faces of their patients and to describe to them the details on the screen. In this commentary, I explain these current laws and the various court responses to them to date. Further, I demonstrate why these abortion regulations violate the ethical principles governing informed consent (...) and why they should be declared unconstitutional based on women’s constitutional rights as settled by Planned Parenthood of Southeastern Pennsylvania v. Casey and physicians’ First Amendment rights. (shrink)

The COVID-19 pandemic has both exposed and created deep rifts in society. It has thrust us into deep ethical thinking to help justify the difficult decisions many will be called upon to make and to protect from decisions that lack ethical underpinnings. This paper aims to highlight ethical issues in six different areas of life highlighting the enormity of the task we are faced with globally. In the context of COVID-19, we consider health inequity, dilemmas in triage and allocation of (...) scarce resources, ethical issues associated with research, ethical considerations relating to tracing apps, and exit strategies such as immunity passports and COVID-19 vaccines. Finally, we consider environmental issues in light of COVID-19. The paper also offers some ethical reflection on these areas as many parts of the world contemplate the recovery phase. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.3 (2002) 425-446 [Access article in PDF] Giving Orders: Theory and Practice in the Fundamental Constitutions of Carolina Vicki Hsueh Indians. Of Edisto Ashapo and Combohe to the South our friends. Of Wando Ituan Sewee and Sehey to the north came to our assistance and were zealous and resolute in it 1000 bowmen In our want supplied us. Q. Spaniards. What we shall (...) doe to the Spaniards if we invade them we brake the peace, if we sit still we loose our reputation with the Indians our friends. Westoes. Inland man eaters. Country. To the northward more sickly, about Ashley River fertile and of a wonderful growth. Tatchequea. A very fruitfull Country 8. days jorney by the North west the Emperor our friend and enemy to the Westoes and to hard for them. Q. Settlem't. 500 people will secure the settlement 1000 perfect it. desires supplys of necessarys till that time Excerpt from Carolina Memoranda in the handwriting of John Locke, Esq., 15 September 1670 Within the last decade, scholars such as James Tully, Barbara Arneil, and Bhikhu Parekh have performed a crucial intervention on modern constitu-tionalism's behalf. 1 Not only has constitutionalism in the modern age been [End Page 425] plagued by assumptions of cultural uniformity and an on-going inability to adjudicate between competing cultural claims, but it has been unable effectively to diagnose those limitations and dilemmas. The root of the problem, James Tully suggests, is ultimately a matter of historical perspective. "[T]he tendency," he writes, "is not to notice the philosophical and ideological debates over the last three hundred years... only the result of these debates is seen—the victorious modern language of constitutional uniformity—and claims for recognition are viewed through its framework as if it were impartial and universal." 2 In response Tully and others have sought to tackle this predicament at its historical root. Identifying modern constitutionalism's colonial origins as a significant part of the problem, their studies address the development of constitutionalism and colonialism as an entwined phenomenon in the early modern period, focusing particularly on the British-American context. In this sense, Locke's Two Treatises of Government stands as an exemplary illustration of the period's entangled colonial and constitutional temperaments. Well-known for its influential articulation of compact and resistance, the Two Treatises, Barbara Arneil argues "were written as a defence of England's colonial policy in the new world against the sceptics in England and the counter-claims of both the aboriginal nations and other European powers in America." 3 Accordingly, present-day constitutionalism continues to bear the weighty legacy of those colonial rationales. "[T]he language of modern constitutionalism," Tully further explains, "which has come to be authoritative was designed to exclude or assimilate cultural diversity and justify uniformity. The design is difficult to see because this 'modern' language has become the customary way of thinking about, reflecting on and envisioning a just constitutional order." Ultimately, Tully submits, citing Wittgenstein, "A picture held us captive. And we could not get outside it, for it lay in our language and language seemed to repeat it to us inexorably." 4This much-needed thickening of constitutionalism's historical context has enriched our awareness of constitutionalism's vexed origins, as it has proffered potent tools for interrogating current cultural adjudication. Yet, a troubling predicament persists. As if caught within the tenacious grip of the language of modern constitutionalism, Tully, Arneil, and Parekh insistently portray seventeenth-century British-American colonialism solely as a straightforward process of appropriation and assimilation without addressing or incorporating the [End Page 426] complex and contingent elements of that history in its emergence. Lacking the various negotiations and accommodations between settler and indigene in ambition and actualization, their portrayals crucially underplay the dynamic relationship between theories of constitutionalism and practices of colonialism—an approach that ultimately serves to reinscribe the narrative of triumphalist progress within their critiques. 5This problematic is the context for my reading of the Fundamental Constitutions of Carolina,1669... (shrink)

Montesquieu is famous as a tireless critic of despotism, which he associates overtly with Asia and the Middle East and not with the apparently more moderate Western models of governance found throughout Europe. However, Vickie B. Sullivan argues that a creaful reading of Montesquieu's enormously influential The Spirit of the Law reveals the surprising result that he recognizes that Europe itself is susceptible to despotic practices - and that the threat emanates not from the East but rather from certain despotic (...) ideas that inform Western institutions and practices. Sullivan guides readers through Montesquieu's sometimes veiled yet sharply critical accounts of Machiavelli, Hobbes, Aristotle, and Plato, as well as various Christian thinkers have brough forth despotic ideas in the form, for example, of brutal Machiavellianism, of Hobbes's justifications for the rule of one, of Plato's reasoning that denied slaves the right of natural defense, and of the Christian teachings that equated heresy with treason. Such ideas, Montesquieu shows, inform such revered European institutions as the French monarchy and the Roman Catholic Church. In this new reading of Montesquieu's masterwork, Sullivan corrects the misconception that it offers simple, objective observations, showing it to be instead a powerful critique of European politics that would become remarkably and regrettably prescient after Montesquieu's death, when despotism repeatedly emerged in Europe with virulent intensity. -- from dust jacket. (shrink)

A key ethical issue arising in data linkage research relates to consent requirements. Patients’ consent preferences in the context of health research have been explored but their consent preferences regarding data linkage specifically have been under-explored. In addition, the views on data linkage are often those of patient groups. As a result, little is known about lay people’s views and their preferences about consent requirements in the context of data linkage. This study explores lay people’s views and justifications regarding the (...) acceptability of conducting data linkage research without obtaining consent. (shrink)

This comprehensively updated and expanded revision of the successful second edition continues to provide detailed coverage of the ever-growing range of research topics in vision. In Part I, the treatment of visual physiology has been extensively revised with an updated account of retinal processing, a new section explaining the principles of spatial and temporal filtering which underlie discussions in later chapters, and an up-to-date account of the primate visual pathway. Part II contains four largely new chapters which cover recent psychophysical (...) evidence and computational model of early vision: edge detection, perceptual grouping, depth perception, and motion perception. The models discussed are extensively integrated with physiological evidence. All other chapters in Parts II, III, and IV have also been thoroughly updated. (shrink)

La façon dont la négligence envers l’enfant est conceptualisée dans les recherches de pointe a un impact notable sur l’organisation des services et les pratiques professionnelles auprès des familles touchées par cette problématique au Québec. Il apparaît donc important de décrire le portrait des parents que ces recherches de pointe génèrent. Cet article examine la structure épistémologique, théorique et méthodologique qui sous-tend la production de ce type de savoir en s’appuyant sur une analyse qualitative d’articles récents publiés dans l’une des (...) plus importantes revues internationales dans le domaine. Les résultats montrent que les recherches de pointe produisent des connaissances sur la négligence envers l’enfant qui excluent plus ou moins radicalement le point de vue des parents et des enfants directement impliqués dans ces situations. (shrink)

The study deals with ekphraseis on works of art and poses the question as to how far these texts can be a reliable source for the study or even the reconstruction of the artefacts they describe. Based on reception theory and readerresponse criticism, in the paper is proposed that as every text, byzantine ekphraseis on artworks presuppose an audience or readership, i. e. the one the author had in mind and on the basis of which he encoded his message. In (...) order to decode this message and by extension to extract any information about the described works of art we must aim to discover their “intended reader”, and identify his or her “horizon of expectations. This proposal is tested in the study of a well known piece of this kind, Manasses’s description of a mosaic floor with a depiction of Earth. The author’s dialogue with the earlier tradition of ekphraseis, his readership’s “horizon of expectations” combined with historical facts, allow us to suppose that Manasses is describing a composition with Xenia scenes and an asarotos motif created in the early byzantine period and preserved in the Great Palace of Constantinople up to the twelfth century. (shrink)

The topological structures imposed on the collection of binary relations on a given set by the symmetric difference metric and the Hausdorff metric provide opportunities for learning about how collections of binary relations with various properties fit into the collection of all binary relations. For example, there is some agreement and some disagreement between conclusions drawn about the rarity of certain properties of binary relations using first the symmetric difference metric and then the Hausdorff metric.

Two scenarios illustrate uses of von Neumann–Morgenstern stable sets in the construction of choice functions. A comparison is made to the construction of choice functions by the selection of maximal elements. A characterization is given of choice functions that are von Neumann–Morgenstern stable set rationalizable by acyclic, asymmetric binary relations. Two examples illustrate the use of the characterization.