Ethical scandals in business are all too common. Due to the increased public awareness of the transgressions of business executives and the potential costs associated with these transgressions, ethical leadership is among the top qualities sought by organizations as they hire and promote managers. This search for ethical leaders intersects with a labor force that is becoming more racially diverse than ever before. In this paper, we propose that the ethical leadership qualities of business leaders may be perceived differently depending (...) upon the race of the leader. Using two experimental studies in the USA, we examine the difference in ethical leadership perceptions between a Black hypocritical CEO and an ethical CEO. Next, we consider a Black ethically ambiguous CEO and an ethical CEO. The findings indicate that a Black leader faces larger negative impact in hypocritical and ambiguous conditions than a similar White leader. There were no significant race effects in the ethical conditions in which a leader demonstrated a personal commitment to ethics through words or actions. We discuss the implications of these findings. (shrink)

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training (...) in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff and students and less than half of clinicians surveyed indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians and students than academics indicated there was a requirement to obtain consent. Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics. (shrink)

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

This article addresses four hypotheses: (a) that corporate social responsibility (CSR) in Asia is not homogeneous but varies among countries, (b) that the variation is explained by stages of development, (c) that globalization enhances the adoption of CSR in Asia, and (d) that national business systems structure the profile of multinational corporations’ CSR. These hypotheses are investigated through analysis of Web site reporting of 50 companies in seven Asian countries: India, Indonesia, Malaysia, the Philippines, South Korea, Singapore, and Thailand. The (...) article concludes that CSR does vary considerably among Asian countries but that this variation is not explained by development but by factors in the respective national business systems. It also concludes that multinational companies are more likely to adopt CSR than those operating solely in their home country but that the profile of their CSR tends to reflect the profile of the country of operation rather than the country of origin. (shrink)

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status (...) of non-human animals. (shrink)

In evolutionary psychology predictions, women’s mate preferences shift between fertile and nonfertile times of the month to reflect ancestral fitness benefits. Our meta-analytic test involving 58 independent reports (13 unpublished, 45 published) was largely nonsupportive. Specifically, fertile women did not especially desire sex in short-term relationships with men purported to be of high genetic quality (i.e., high testosterone, masculinity, dominance, symmetry). The few significant preference shifts appeared to be research artifacts. The effects declined over time in published work, were limited (...) to studies that used broader, less precise definitions of the fertile phase, and were found only in published research. (shrink)

A summary of the existing literature related to moral distress (MD) and the paediatric intensive care unit (PICU) reveals a high-tech, high-pressure environment in which effective teamwork can be compromised by MD arising from different situations related to: consent for treatment, futile care, end-of-life decision making, formal decision-making structures, training and experience by discipline, individual values and attitudes, and power and authority issues. Attempts to resolve MD in PICUs have included the use of administrative tools such as shift worksheets, the (...) implementation of continuing education, and encouragement to report. The literature does not yet show these approaches to be effective in the resolution of MD. The need to acknowledge MD among PICU teams is discussed and an argument made that, to facilitate understanding among team members, practice stories need to be shared. (shrink)

Friedrich Nietzsche was a troublesome genius, a figure outside the mainstream philosophical tradition whose very apartness has made him central to contemporary philosophy. Nietzsche and Political Thought reclaims the political implications of Nietzsche's work: it shows how his philosophy of power addresses key issues in modern political thought especially those having to do with the historical and cultural nature of human agency.In this thought-provoking study, Mark Warren claims entirely new ground. He develops a "postmetaphysical" political philosophy that provides a (...) link between Nietzsche's work and the later philosophies of the Frankfurt School and Michel Foucault.Warren comes to terms with Nietszche's views on power, freedom, domination, equality, ideology - topics that recent interpretations have neglected in favor of a focus on the literary and philosophical aspects of his work, but that in fact make these literary and philosophical concerns relevant to social and political thought. Importantly, Warren draws a distinction between the implications of Nietzsche's theories concerning power and agency for contemporary political thought and Nietzsche's own politics. He demonstrates how Nietzsche's actual political views did not reflect - and in large part falsified - his own philosophical insights which taken by themselves point toward a pluralistic society in which egalitarianism underscores individuality. But his politics, Warren argues, derived too heavily from a deficient understanding of modern social and political organization.Mark Warren is Visiting Assistant Professor of Political Science at Northwestern University. Nietzsche and Political Thought is included in the series Studies in Contemporary German Social Thought, edited by Thomas McCarthy. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...) those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. (shrink)

Informal political representation can be a political lifeline, particularly for oppressed and marginalized groups. Such representation can give these groups some say, however mediate, partial, and imperfect, in how things go for them. Coeval with the political goods such representation offers these groups are its particular dangers to them. Mindful of these dangers, skeptics challenge the practice for being, inter alia, unaccountable, unauthorized, inegalitarian, and oppressive. These challenges provide strong pro tanto reasons to think the practice morally impermissible. This paper (...) considers the question: On what conditions is the informal political representation of oppressed and marginalized groups permissible? By responding to skeptics’ challenges, I develop a systematic account of moral constraints that, if adopted, would make such representation permissible. The account that emerges shows that informal political representatives (IPRs) must aim to fulfill two sets of sometimes conflicting duties to the represented: democracy within duties, which concern how the representative treats and relates to the represented, and justice without duties, which concern how the representative’s actions advance the aims of the representation. (shrink)

_Eros for the Other_ takes up the problem of how truth claims and ethical norms can survive the increasingly radical recognition of the historical, cultural, pluralistic, and often ideological character of human experience. Sharing with postmodernism a suspicion of totalizing forms of knowledge and practice, Wendy Farley parts with postmodernism in defending the possibility of truth and ethics. Arguing that reality occurs in the concrete existence of actual beings, she develops an interpretation of the nature of knowledge as an (...) eros for the other—as an openness to the distinctive beauties and fragilities of other creatures. Employing Plato, Levinas, Hannah Arendt, Iris Murdoch, Anne Carson, and representatives of Continental philosophy and feminist theory, _Eros for the Other _constructs an original argument for the interdependence of truth, ethics, and pluralism. Through dialogues with Western thought and its critics an original vision emerges of the way reason discerns reality, experiences beauty, and lives compassionately in the midst of the plurality of concrete, historical existence. (shrink)

Informal political representation—the phenomenon of speaking or acting on behalf of others although one has not been elected or selected to do so by means of a systematized election or selection procedure—plays a crucial role in advancing the interests of groups. Sometimes, those who emerge as informal political representatives (IPRs) do so willingly (voluntary representatives). But, often, people end up being IPRs, either in their private lives or in more public political forums, over their own protests (unwilling representatives) or even (...) without their knowledge (unwitting representatives)—that is, they are conscripted. None of the few theories of informal political representation extant accommodate conscripted IPRs. The account detailed here introduces the phenomenon of conscripted informal political representation and explains its place in a complete theory of informal political representation. Conscripted IPRs can, like their voluntary counterparts, come to have significant power to influence how various audiences regard those for whom the conscripted IPRs speak or act. Upon attaining such power to influence, conscripted IPRs, like their voluntary counterparts, come to have pro tanto duties to those they represent—duties that arise despite IPRs’ unwittingness or unwillingness. Understanding the phenomenon of conscripted informal political representation allows us to surface essential normative questions about informal political representation that are otherwise occluded. (shrink)

This article evaluates the ethical implications of the practice of cause-related marketing (CRM). The authors note howCRMis consistent with a contemporary rhetoric that argues that consumers are displaying a developing interest in the social commitments of the corporate world. However, following the work of Zygmunt Bauman, the authors suggest that CRM actually threatens these sentiments. Of particular significance is its incorporation of a charitable act within an act of exchange that is mediated by marketing technique. This serves to prevent any (...) encounter with Bauman’s “Other.” Instead, the pretense of engagement has to be preserved by increasingly vociferous avowals of concern. These become examples of the ecstatic, a seductive force that renders the extreme meaningless and amoral. Finally, the authors argue that the nature of ethical commitment produced by CRM cannot be divorced from the instrumental benefits that are generated. (shrink)

How can dispute records shed light on the study of dispute settlement processes and their social and political underpinnings? This volume addresses this question by investigating the interplay between record-making, disputing process, and the social and political contexts of conflicts. The authors make use of exceptionally rich charter materials from the Iberian Peninsula, Italy, and Scandinavia, including different types of texts directly and indirectly related to conflicts, in order to contribute to a comparative survey of early medieval dispute records and (...) to a better understanding of the interplay between judicial and other less formal modes of conflict resolution. Contributors are Isabel Alfonso, José M. Andrade, François Bougard, Warren C. Brown, Wendy Davies, Julio Escalona, Kim Esmark, Adam J. Kosto, Juan José Larrea, André Evangelista Marques, Josep M. Salrach, Igor Santos Salazar, and Francesca Tinti. (shrink)

Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has (...) been set at a level where many people without harmful disease are nonetheless diagnosed. We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. Maldetection overdiagnosis arises because, at the time the diagnosis is made and despite the presence of a 'gold standard' diagnostic test, it is not possible to discriminate between harmful and non-harmful cases of the index disease. We illustrate maldetection overdiagnosis using the example of thyroid cancer. While there is some overlap between misclassification and maldetection overdiagnosis, this conceptual analysis helps to clarify the phenomenon of overdiagnosis and is a necessary first step in developing strategies to address the problem. (shrink)

an exemplar of an approach that takes the human mind to be largely the product of social and cultural factors with negligible contributions from biology. The author argues that on the contrary, his sociological theory of the categories is compatible with the possibility of innate cognitive capacities, taking causal cognition as his example. Whether and to what extent there are such innate capacities is a question for research in the cognitive neurosciences. The extent to which these innate capacities can then (...) be explained by natural selection remains an open question for empirical investigation. Key Words: categories • causality • cognition • Durkheim • evolutionary psychology. (shrink)

Biomedical innovation and translation are increasingly emphasizing research using “big data.” The hope is that big data methods will both speed up research and make its results more applicable to “real-world” patients and health services. While big data research has been embraced by scientists, politicians, industry, and the public, numerous ethical, organizational, and technical/methodological concerns have also been raised. With respect to technical and methodological concerns, there is a view that these will be resolved through sophisticated information technologies, predictive algorithms, (...) and data analysis techniques. While such advances will likely go some way towards resolving technical and methodological issues, we believe that the epistemological issues raised by big data research have important ethical implications and raise questions about the very possibility of big data research achieving its goals. (shrink)

Public health plays an important, albeit often unnoticed, role in protecting and promoting the health of populations. The activities of public health are complex, performed by multiple professionals, and range from the innocuous to the intrusive. Ethical analyses in public health reflect some of this complexity and fragmentation, with no one approach able to capture the full range of ethical considerations raised by public health activities. There are however, good reasons why we should pursue such analyses. Providing a robust ethical (...) framework for public health may promote the identity and function of public health, address some of the shortcomings of utilitarianism, and help to combat the threat that public health faces through lack of political will in many parts of the world.In this paper I argue that Alasdair MacIntyre’s account of practices and virtues can make a valuable contribution to public health ethics. The first part of the paper argues that public health may properly be described as the type of practice that provides an arena for the exercise of virtues. This is followed by an analysis of the three virtues of honesty, courage and justice in public health practice. Using virtue theory captures morally important elements of public health and helps to maintain awareness of significant moral values in the practice of public health. Such awareness is crucial in maintaining and defending the integrity of public health. (shrink)

COVID-19 has created significant concern surrounding the impact of pandemic lockdown on mental health. While the pandemic lockdown can be distressing, times of crisis can also provide people with the opportunity to think divergently and explore different activities. Novelty seeking, where individuals explore novel and unfamiliarly stimuli and environments, may enhance the creativity of individuals to solve problems in a way that allows them to adjust their emotional responses to stressful situations. This study employs a longitudinal design to investigate changes (...) in novelty seeking and mental health outcomes before, during, and after COVID-19 pandemic lockdown, among a group of students from a university in southeast China. Participants were surveyed at three points: November, 2019 ; between February and March, 2020 ; and between May and June, 2020. Cross-sectionally, correlation analysis indicated that greater novelty seeking was associated with lower levels of stress, anxiety, and depression at all three time points. Univariate latent curve modeling indicated a growth trajectory in which novelty seeking increased over time and then remained high during the post-lockdown period. Stress, anxiety, and depression all showed V-shaped growth trajectories in which these variables decreased during lockdown, before increasing in the post-lockdown period. Multivariate LCM indicated the growth trajectory for novelty seeking was associated with the growth trajectories for stress, anxiety, and depression. This suggests that the observed decreases in stress, anxiety, and depression during the lockdown period may be attributable to the sample’s observed increase in novelty seeking. These findings are valuable in that they challenge the notion that lockdown measures are inherently detrimental to mental health. The findings indicate the important role of novelty seeking in responding to crises. It may be possible for future public health measures to incorporate the promotion of novelty seeking to help individuals’ respond to stressful situations and maintain good mental health in the face of crises. (shrink)

"This collection of works is ambitious, well documented, thoroughly—though not turgidly—referenced, and comprehensively indexed.

Bioethics, Volume 35, Issue 7, Page 623-633, September 2021.

Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, (...) and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major breaches of medical trust such as these typically lead to government inquiries, revisions of ethical guidelines, and substantive policy change in an effort to re-establish public and patient trust. We argue that the medical profession has an ethical obligation to put mechanisms in place to protect vulnerable patients from abuses of trust, to monitor colleagues' competence, and to be prepared to blow the whistle to protect patients who are not in a position to recognize misplaced trust. Such mechanisms will act disprosportionately to reduce harm to women as patients. (shrink)

The ethical development of business graduates is a critical issue. Yet, little empirical evidence exists on the factors affecting business graduate ethical development and behaviour using an Islamic perspective. This study examines the effects of mentoring support, the perceived standard of ethical conduct of peers, and individual ethical attributes of National female business graduates from the United Arab Emirates. Research has shown that formal and informal mentoring relationships benefit new employees by enabling them to further learn and grow within an (...) organisation. On the other hand, some employees have also shown that these relationships can have a negative impact on a new employee’s ethical orientation. The aim of this study is to investigatethe ethical orientations of Emirati female business graduates as they move from the relative sanctity of home and university into a new multicultural, westernised business environment. The results suggest that the ethical evaluations and behavioural intentions of Emirati graduates are affected by a multiplicity of sources including professional bodies and both mentors and peers in the workplace. It may be prudent at such a significant time in the UAE’s development that educators consider introducing ethical education into tertiary curriculum. (shrink)

Choreography and Ceremony: The Artful Side of Action "Actions" are normally thought of as taken by individuals. But to understand their quality, it is not enough to classify them from the perspective of individual psychology (rational vs. emotional, technical vs. artistic, etc.). We need to grasp their relation to those forms of collective life which have a historical existence independent of specific individual action (institutions, the conventions of social gathering, the organizing principles of games, architecture, music, ritual, etc.). This paper (...) focuses on what characteristics such forms of collective life share, not what seems to separate them (eg. into sacred vs secular, technology vs creative art). The main features emphasized are their choreography, that is their enactment within commonly understood patterns of a spatial and temporal kind, as well as rules of interactive movement; and their ceremonial character, something which can be found in simple situations such as a conversation or a meal, though much more intensely in major religious ritual. A particularly resonant image for these enactments of social life is the dance. Because there is a ceremonial aspect to all social interaction, the paper argues that individual action, necessarily oriented to the social context, always has an "artful" side (however habitual or technical). The paper draws on the writings of Wittgenstein on action, and those of Collingwood on language and art, to shape the argument. Illustrations are provided of the "artful" employment of language (especially by actors on the stage), the "artful" side of material culture, and from the author's own ethnographic studies, the significance of dance among Sudanese refugees in Ethiopia. (shrink)

Recent evidence from psychological science and genetics suggests that genetic influences underlie all behavior as well as the most worrisome social inequalities. This may be considered to call into question traditional conceptions of agency and agent responsibility. They could be thought to be undermined if gene-environment transactions were sufficiently potent in influencing behaviors. Here we identify the theoretical parameters that require investigation and the conceptual challenges to agent responsibility that arise from research in behavior genetics. We (i) introduce the empirical (...) basis of the discussion, (ii) identify the particular questions that arise from considering the connection between behavior genetics and agent responsibility in the context of the legal system, (iii) bring into focus the general challenges to agent responsibility, and (iv) outline a potential resolution. (shrink)

Latent variable modeling has revealed important conundrums in the DSM classification system. We agree that the network perspective has potential to inspire new insights and resolve some of these conundrums. We note, however, that alone it cannot really help us understand etiology. Etiology, not comorbidity, is the fundamental question.

This book brings together a range of international studies to support the implementation of cooperative group work in the classroom. In spite of extensive research into the benefits of this approach, in many countries, it is not widely used, largely due to a lack of understanding of how to put this into practice in the classroom. Starting from an exploration of the theoretical perspectives that underpin this pedagogy, the challenges for including pupils with special educational needs and related status issues (...) of pupils are explored. Amongst the themes explored are how creative approaches, such as Storyline, support engagement particularly for second language learning; how working with young children using cooperative group work can develop writing skills; and how teachers can work together in an effective, collaborative, and sustained manner in a professional learning community. The final chapter provides a vivid example of one teacher’s personal journal to develop her understanding of the power of cooperation in creating bridges to meaningful learning for all learners. This book was originally published as a special issue of _Education 3-13. _. (shrink)

Many healthcare practices expose people to risks of harmful outcomes. However, the major theories of moral philosophy struggle to assess whether, when and why it is ethically justifiable to expose individuals to risks, as opposed to actually harming them. Sven Ove Hansson has proposed an approach to the ethical assessment of risk imposition that encourages attention to factors including questions of justice in the distribution of advantage and risk, people’s acceptance or otherwise of risks, and the scope individuals have to (...) influence the practices that generate risk. This paper investigates the ethical justifiability of preventive healthcare practices that expose people to risks including overdiagnosis. We applied Hansson’s framework to three such practices: an ‘ideal’ breast screening service, a commercial personal genome testing service, and a guideline that lowers the diagnostic threshold for hypertension. The framework was challenging to apply, not least because healthcare has unclear boundaries and involves highly complex practices. Nonetheless, the framework encouraged attention to issues that would be widely recognised as morally pertinent. Our assessment supports the view that at least some preventive healthcare practices that impose risks including that of overdiagnosis are not ethically justifiable. Further work is however needed to develop and/or test refined assessment criteria and guidance for applying them. (shrink)

Synthetic biology (synbio) involves designing and creating new living systems to serve human ends, using techniques including molecular biology, genomics, and engineering. Existing bioethical analyses of synbio focus largely on balancing benefits against harms, the dual-use dilemma, and metaphysical questions about creating and commercializing synthetic organisms. We argue that these approaches fail to consider key feminist concerns. We ground our normative claims in two case studies, focusing on the public good, who holds and wields power, and synbio research projects’ particularity (...) and context. Attention to feminist concerns is essential for synbio to realize its potential in ethically justifiable ways. (shrink)

Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side (...) effects. These harms seem to outweigh any putative benefit of knowing about a cancer that would not have caused problems if left undiscovered. In addition to harms to patients, thyroid cancer overdiagnosis leads to significant opportunity costs at a societal level, due to costs of diagnosis and treatment. Unlike many other overdiagnosed cancers, accurate risk stratification is possible with thyroid cancer. At the individual patient level, use of this risk information might support informed choice and/or shared decision-making, as mandated by clinical ethics frameworks. And this approach might, to some extent, help to reduce rates of diagnosis and intervention. In practice, however, it is unlikely to stem the rising incidence and associated harms and costs of overdiagnosed thyroid cancer, especially in situations where health professionals have conflicts of interest. We argue in this article that thyroid cancer overdiagnosis may be usefully understood as a public health problem, and that some public health approaches will be readily justifiable and are more likely to be effective in minimising its harms. (shrink)

Warren and Dresang comment on the contributions from a psycholinguistic perspective, highlighting close relations between the respective research on events and proposing that, for example, verbs may indeed directly pre‐activate templates of the typically involved event participants.