In Sweden, most patients are recruited into biobank research by non-researcher doctors. Patients' trust in doctors may therefore be important to their willingness to participate. We suggest a model of trust that makes sense of such transitions of trust between domains and distinguishes adequate trust from mistaken trust. The unique position of doctors implies, we argue, a Kantian imperfect duty to compensate for patients' mistaken trust. There are at least three kinds of mistaken trust, each of which (...) requires a different set of countermeasures. First, trust is mistaken when necessary competence is lacking; the competence must be developed or the illusion dispelled. Second, trust is irrational whenever the patient is mistaken about his actual reasons for trusting. Care must therefore be taken to support the patient's reasoning and moral agency. Third, some patients inappropriately trust doctors to recommend only research that will benefit them directly. Such trust should be counteracted by nurturing a culture where patients expect to be asked occasionally to contribute to the common good. (shrink)

The need to make young scientists aware of their social responsibilities is widely acknowledged, although the question of how to actually do it has so far gained limited attention. A 2-day workshop entitled “Prepared for social responsibility?” attended by doctoral students from multiple disciplines in climate science, was targeted at the perceived needs of the participants and employed a format that took them through three stages of ethics education: sensitization, information and empowerment. The workshop aimed at preparing doctoral students (...) to manage ethical dilemmas that emerge when climate science meets the public sphere (e.g., to identify and balance legitimate perspectives on particular types of geo-engineering), and is an example of how to include social responsibility in doctoral education. The paper describes the workshop from the three different perspectives of the authors: the course teacher, the head of the graduate school, and a graduate student. The elements that contributed to the success of the workshop, and thus make it an example to follow, are (1) the involvement of participating students, (2) the introduction of external expertise and role models in climate science, and (3) a workshop design that focused on ethical analyses of examples from the climate sciences. (shrink)

Doctor Marti is to be commended for compressing such a rich variety of historical reminders and flashes of philosophical insight within the scope of his brief and suggestive paper. Among the important reminders culled from the tradition are, first of all, the pivotal importance of St. Augustine’s fusion of philosophical inwardness and Christian doctrine, then a correct and careful estimation of Kant’s location of the ethically active self within the noumenal order, and finally a lucid synthesis of Schelling’s insights into (...) the possibility of a philosophical religion. Marti understands that to repeat the tradition philosophically is to renew and restore it. But he also brings novel insights to bear upon the Kantian-Hegelian tradition, the most striking of which are the assertions that the work of ratiocination is guesswork, and that obligation becomes objective only in and with the act of taking responsibility. Each of these gems deserves to be cut, polished, and set within its own extended treatment. (shrink)

An “objectified God” does not satisfy. On this point, surely all will agree with Doctor Marti. To seek an “objectivie essence” behind God’s presence is implicitly to deny the reality of that presence. In subjecting the idea of God to ratiocination, the absoluteness and infinity of God are compromised, for a God-object must assume a particular existence over against the divine essence, and thereby abandon God’s freedom to be, the divine essence as pure relation. On this, reason and faith are (...) in perfect harmony: when God is reduced to an object, it is no longer God that is in view. (shrink)

Fritz Marti is a “true believer” in the transcendental method of philosophy pioneered by Fichte and modified by Schelling. With it he links the Augustinian religious theme that at the very center of our own self-conscious life we can encounter God who is our ground. Marti ranges freely between these Augustinian and idealist anchors, reading intervening figures such as Descartes and Kant in their terms. The result is his own vital personal testimony, a philosophico-religious “profession of faith” that illumines the (...) powerful attraction this strand of German idealism had, and still has, for many. Marti began his philosophical education with Fichte, and still employs Fichte’s insights to carry out transcendentally the analysis of the free, self-conscious “I” that Augustine initiated. But Marti also turns to Schelling for what Fichte’s analysis largely neglects, namely, a developed idealistic account of God as ground of the self’s freedom, and serious attention to human encounters with God in the history of religion. (shrink)

With regard to the acta Dei, Fritz Marti rightly tells us that God named himself “I am,” the One who is present, adsum, the One who Acts. Could we not add that God is the One who forces us to act, whose very presence is the necessitating ground of our being? How deeply Augustine grasped this reality of being before God, how intensely he felt the desire to believe in the reality of his unbelief. “For I kept saying within myself, (...) ‘Lo, let it be now, let it be now’ ecce modo fiat, modo fiat, and as I uttered the phrase I was on the brink of resolution. I was on the point of action and I acted not and yet I did not fall back to my former state but stood hard by and drew breath. And I tried again and came a little nearer, yet a little nearer, and now I was all but touching and grasping it; and I did not reach or touch or grasp it, as I shrank from dying unto death, and from living unto life and the worse which was ingrained grew stronger in me than the better which was untrained, plusque in me valebat deterius inolitum, quam melius insolitum, and that very instant which was to make me another man struck greater terror into me, the nearer it approached; but neither repelled nor daunted me but kept me in suspense”. Before God the opposites that control our existence are felt with pain and fear, the longing to turn toward God is challenged by the forces that turn us from God, the movement toward bears within it the movement away, the escape, the need to flee and reject. How weak we discover our faith to be, how powerful we find our fear and distrust. How easily we realize the vanities of vanities, vanitates vanitatum, the childishness of our being compared to God. Deep within the experience of the “I” we see the conflicts that drive us from doubt to doubt and force us to that despair of sin that has so deeply separated us from God. The “religiosity of reason,” can it be any other than this struggle of opposites that we bear in the self and know in revelation? (shrink)

This book explores the future of doctoral research and what it means to be involved in all stages of the process, providing international insights into what's changing, why it's changing and how to work best with these changes. It looks at the key issues that have been thrown into sharp relief by crises such as world pandemics. Drawing on work from outstanding authors, this book shows the ways in which the doctoral process has altered the supervisor/supervisee model, the challenges that (...) now need to be managed and demonstrates the importance of aligning all the stakeholders, systems and processes to ensure a successful future for doctoral education. Bringing together a range of perspectives, innovative practices and rigorous research this book tackles topics such as: how doctoral research changes in keeping with the global expansion and transformation of doctoral education programs the significant influence funding bodies - be they charities, governments, businesses, or non-governmental agencies - can have on doctoral research the extent to which doctoral research penetrates daily life and vice versa, and how to encourage and embed an ethical approach to research, as well as university responses to external challenges Uniquely international and bringing together the many stakeholders in the research business, this book is essential reading for all doctoral supervisors, candidates, and anyone involved in designing or organising research programmes for early career researchers and doctoral students. (shrink)

To be human is to be autonomous, yet this is a trait that most of us lack. We are subject to forces external to our being. We are workers; we are citizens; we are needful creatures. Humanity-proper in these times of neoliberal omnipotence is defined differently. The key terms are familiar: personal betterment, personal responsibility, productivity, pleasantness. A forked tongue slithers in our conscience, tells us that these are the traits of the human condition. Through Bataille, this paper argues (...) the substrate of these oft repeated familiar mantras are other. Neoliberal subjects, propelled by need, understand themselves along the axis of the useful choice. The paper turns to myth to understand the interdependence of need and choice, and how this interdependence posits being as always in desire but never in pleasure. Revisiting Don Giovanni, a character central to Acéphalic thought, and the commentary of Søren Kierkegaard, we think in terms of non-abstraction, of pleasurably floating in change, rather than toiling in desire. For it is by grace in the form of chance, that at the very time of transgression, that we – in and for an instant – become human, become as the sacred in the flesh. (shrink)

The hospital has legal liability. Does it also have moral responsibility? Is it a moral agent, and if so in what sense? There are two issues involved, one conceptual and the other normative. The conceptual issue is whether a hospital can be morally responsible. If seen not only as a physical facility but as a formal organization, it can be said to act rationally, choose between alternatives, and affect human beings. It thus satisfies die criteria for moral responsibility, (...) even though it is not a person. Though moral responsibility can be attributed intelligibly to a hospital, such responsibility can be assumed only by those within it who act for it. Such responsibility is agent responsibility and may be shared in a number of ways. Hospital responsibilities can be separated from the professional moral responsibility and the personal moral responsibility held by doctors, nurses, and others within a hospital. Assuming these three types of responsibility makes possible conflicts of responsibility for those who hold them. Normatively, the moral responsibility of the hospital is appropriately limited by its purpose and is primarily administrative. It has designatable moral responsibilities to its patients, doctors and nurses, and the public. These can be distinguished from the responsibilities of doctors and nurses to the public. The responsibility of a doctor on the hospital staff is different from the responsibility of a doctor who simply practices in the hospital; that of a staff nurse from that of a private nurse. The difference is in large part a function of the one sharing die responsibility of the hospital and the other not. An analysis of a hospital's moral responsibilities suggests structures appropriate to a hospital that wishes to meet its moral responsibilities. CiteULike Connotea Del.icio.us What's this? (shrink)

Postgraduate research has undergone unprecedented change in the past ten years, in response to major shifts in the role of the university and the disciplines in knowledge production and the management of intellectual work. New kinds of doctorates have been established that have expanded the scope and direction of doctoral education. A new audience of supervisors, academic managers and graduate school personnel is engaging in debates about the nature, purpose and future of doctoral education and how institutions and departments can (...) best respond to the increasing demands that are being made. Discussion of the emerging issues and agendas is set within the context of the international policy shifts that are occurring and considers the implications of these shifts on the changing external environment. This engaging book acquaints the readers with new international trends in doctoral education identifies new practices in supervision, research, teaching and learning enables practitioners of doctoral education to contribute to the debates and help shape new understandings questions the purposes of doctoral study and how they are changing considers the balance between equipping students as researchers and the conduct of original research Including contributions from both those who have conducted formal research on research education and those whose own practice is breaking new ground within their universities, this thought-provoking book draws on the expertise of those currently making a stimulating contribution to the literature on doctoral education. (shrink)

Medicine has always existed in a marketplace, and there have been extensive discussions about the ethical implications of commerce in health care. For the most part, this discussion has focused on health professionals’ interactions with pharmaceutical and other health technology industries, with less attention given to other types of commercial influences, such as corporatized health services and fee-for-service practice. This is a significant lacuna because in many jurisdictions, some or all of healthcare is delivered in the private sector. Using the (...) exemplar of Assisted Reproductive Technologies (ART), this paper asks: what, if any, responsibilities do doctors have to challenge the distorting influence of commerce in healthcare, other than those arising from their own interactions with health technology companies? ART provides a good focus for this question because it is an area of practice that has historically been provided in the private sector. First, we describe a range of concepts that offer helpful heuristics for capturing how and when doctors can reasonably be said to have responsibilities to resist commercial distortion, including: complicity, acquiescence, wilful ignorance, non-wilful ignorance, and duplicity. Second, we present ways that individual doctors can act to stop questionable behaviour on the part of their colleagues, clinics/corporations, and their profession. Third, we note that there are many situations where change cannot be achieved by individuals acting alone, and so we consider the responsibilities of health professionals as collectives as well as the role that professional bodies and regulators should play. (shrink)

Contrary to the usual discussion of lying or deceiving in medical ethics literature where the lying or deceiving is done by the doctor or surgeon, this paper deals with lying or deceiving on the part of the patient. Three cases involving HIV-infected male homosexual or bisexual persons are presented. In each case the patient deceives or wants the doctor to deceive a third party on his behalf. Are such deceptions or lies expressions of compassion? Are they in the patient's best (...) interests? Do they compromise the doctor's integrity? It is submitted that societal attitudes towards male homosexual acts were internalised by the men described in these cases. Thus, a dichotomy was created between the private life and the public image. Fear of condemnation by the doctor or others restricted communication towards the goal of the maintenance of the patient's health. The lack of trust which inhibits truth-telling results in mutual and progressive isolation and impedes the provision of optimal care. (shrink)

Objective: To assess the opinions and practice patterns of obstetrician-gynaecologists on acceptance and use of free drug samples and other incentive items from pharmaceutical representatives.Methods: A questionnaire was mailed in March 2003 to 397 members of the American College of Obstetricians and Gynecologists who participate in the Collaborative Ambulatory Research Network.Results: The response rate was 55%. Most respondents thought it proper to accept drug samples , an informational lunch , an anatomical model or a well-paid consultantship from pharmaceutical representatives. A (...) third of the respondents thought that their own decision to prescribe a drug would probably be influenced by accepting drug samples. Respondents were more likely to think the average doctor’s prescribing would be influenced by acceptance of the items than theirs would be . Respondents who distributed drug samples to patients indicated doing so because of patients’ financial need and for their convenience and less so as a result of knowledge of the efficacy of the sample product . A third of respondents agreed that interactions with industry should be more strictly regulated.Conclusion: Obstetrician-gynaecologists largely indicated that they would act in accordance with what they think is proper regarding accepting incentive items from pharmaceutical representatives. Although accepting free drug samples was considered to be appropriate more often than any other item, samples were most commonly judged to be influential on prescribing practices. The widely accepted practice of receiving and distributing free drug samples needs to be examined more carefully. (shrink)

Periodic attacks of uncertain origin, where the clinical presentationresembles epilepsy but there is no evidence of a somatic disease, arecalled Pseudo-Epilepsy or Pseudo-Epileptic Attack Disorder (PEAD). PEADmay be called a `non-disease', i.e. a disorder on the fringes ofestablished disease patterns, because it lacks a rationalpathophysiological explanation. The first aim of this article is tocriticize the idea, common in medical science, that diseases are realentities which exist separately from the patient, waiting to bediscovered by the doctor. We argue that doctor and (...) patient construct adisease, and that the construction of the disease PEAD includes manynormative evaluations. The second aim is to provide insight into thesuffering of patients with PEAD. We focus on three aspects of thepatient, identity, autonomy and responsibility. We present somecharacteristic descriptions of (pseudo-)epileptic attacks by FjodorDostoevsky, Gustave Flaubert and Thomas Mann. We argue that diagnosingPEAD reduces a meaningful life event into an insignificant, thoughintriguing, medical phenomenon, and that the patient will not benefitfrom being diagnosed as having PEAD. (shrink)

This article reports the results of a survey, by mailed questionnaire, of the attitudes, values and practices of doctors in Singapore with respect to the doctor-patient relationship. Questionnaires were sent to a random sample of 475 doctors (261 general practitioners and 214 medical specialists), out of which 249 (52.4%) valid responses were completed and returned. The survey is the first of its kind in Singapore. Questions were framed around issues of medical paternalism, consent and patient autonomy. As the (...) doctors were exposed to Western ethical concepts in their training, we were not surprised to find that they would mostly allow patients some say in decision-making and keep patients reasonably informed. In respecting patient autonomy, they would usually seek to influence patient choice by persuasion. However, the residual "Asian-ness" of doctors in Singapore gives rise to some inconsistencies between values and practices. Many doctors still believe that a number of their patients are incapable of rational choice. There is some lack of openness in telling patients the whole truth. When patients choose to refuse treatment, many doctors are prepared to involve family members in making a consensus decision. Doctors were also asked how they made ethical judgements in the face of dilemmas, and how they would like disputes with patients to be resolved. By and large, the doctors prefer to make their own judgements rather than to rely on rules. They also wish to keep the law courts out of disputes with patients, preferring less public ways of settling disputes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 122.1 (2001) 107-129 [Access article in PDF] Imperitia: The Responsibility Of Skilled Workers In Classical Roman Law Susan D. Martin BY THE EARLY SECOND CENTURY A.D., the Roman jurists were invoking the term imperitia, lack of skill or experience, as a basis for the legal responsibility of skilled individuals who damaged another's property in the course of their work. The term is invoked (...) in a broad range of situations and doubtless was applicable in innumerable others of similar type. For example, you entrust a gem to a jeweler to be set. It breaks in the process. A doctor, hired to perform surgery, further harms the patient. You give a cup to an artisan to be carved. The cup shatters. 1 All of these examples, taken from the Digest, presuppose a similar situation: A person is employed to do a job and is entrusted with the material necessary for the completion of the work, usually a moveable object, a slave, or an animal. In the course of the work, this material, whether inanimate or animate, sustains damage. Who should be responsible and on what grounds?A series of texts preserved in the Digest illustrates how, over the course of the classical period of Roman jurisprudence, the jurists articulated and interpreted imperitia as a key concept for use in legal disputes dealing with a broad range of individuals employed in the workforce of the empire. As increased scholarly attention is devoted to the study of the Roman working population from a legal perspective, an examination of imperitia will shed light on one of the principal substantive tools developed to regulate artisans and skilled workers of all kinds. 2 The surviving Digest texts permit the reconstruction of key elements of the [End Page 107] jurists' conception of the employment relationship as it was encompassed in the contract of locatio conductio operis, the contract of lease and hire of a job. 3 The question of the worker's responsibility for skilled work is a central element of the law with regard to this contract. I will argue that the jurists' development of imperitia as a legal doctrine was the product of a complex relationship between law and its social and economic context. 4 This process of legal development reveals a great deal about the methods the jurists employed in dealing with certain segments of the Roman workforce. It emerges with relative clarity from the texts that the jurists presume that these contracts are designed for the hire of workers who are capable of assuming a considerable degree of risk for the skilled execution of their work as an implied feature of the contract. But the jurists never state clearly what standard should be used to evaluate the worker's performance. Analysis of the evidence shows that the jurists tend to favor a method of evaluation that focuses on the quality of the performance based upon external, objective criteria, rather than the individualized fault of the worker. 5 From this reconstruction of how the law functioned, one can speculate about what the advantages of this regime were from the jurists' point of view and how adequately or inadequately jurists' law functioned with regard to the diversity of workers known to have existed in the workforce of the empire. The results of this investigation have implications for our understanding of the activities of skilled and craft workers, especially in the city of Rome. The inhabitants of cities in the empire became increasingly accustomed to the availability of a wide variety of goods and services and in all likelihood purchased them or contracted for them from individuals with whom they had no other connections, that is, the workers themselves or merchants or traders. 6 The legal regime described here presupposes the existence of a multiplicity of such workers whose concerns penetrated [End Page 108] the legal system, who came to the attention of the Roman jurists, and who were, apparently, able to maneuver to some extent within the legal system. 7The concept of imperitia originated as the jurists developed... (shrink)

The Leuphana Semester at Leuphana University Lüneburg, together with the module “Science bears responsibility” demonstrate how innovative methods of teaching and learning can be combined with the topic of sustainable development and how new forms of university teaching can be introduced. With regard to module content, it has become apparent that, due to the complexity of the field of sustainability, a single discipline alone is unable to provide analyses and solutions. If teaching in higher education is to adequately deal (...) with this complexity, then it is necessary to develop inter- and transdisciplinary approaches that go beyond a purely specialist orientation. (shrink)

In a world with limited resources, allocation of resources to certain individuals and conditions inevitably means fewer resources allocated to other individuals and conditions. Should a patient's personal responsibility be relevant to decisions regarding allocation? In this project we combine the normative and the descriptive, conducting an empirical bioethical examination of how both Norwegian and British doctors think about principles of responsibility in allocating scarce healthcare resources. A large proportion of doctors in both countries supported including (...) responsibility for illness in prioritization decisions. This finding was more prominent in zero‐sum scenarios where allocation to one patient means that another patient is denied treatment. There was most support for incorporating prospective responsibility (through patient contracts), and low support for integrating responsibility into co‐payments (i.e. through requiring responsible patients to pay part of the costs of treatment). Finally, some behaviours were considered more appropriate grounds for deprioritization (smoking, alcohol, drug use)—potentially because of the certainty of impact and direct link to ill health. In zero‐sum situations, prognosis also influenced prioritization (but did not outweigh responsibility). Ethical implications are discussed. We argue that the role that responsibility constructs appear to play in doctors' decisions indicates a needs for more nuanced—and clear—policy. Such policy should account for the distinctions we draw between responsibility‐sensitive and prognostic justifications for deprioritization. (shrink)

As Sorcerer Supreme, Doctor Stephen Strange has had several occasions in which he had to deal with the concept of a personal God. Despite his lack of traditional faith, there are important instances in which Doctor Strange acknowledges the Creator God using expressions drawn from the Western monotheistic traditions. In his Metaphysics, the ancient Greek philosopher Aristotle presents the idea of God, or more specifically a god among the gods, who is responsible for the origin and operation of the whole (...) universe. A more helpful image of God can be found in the writing of Saint Thomas Aquinas, who formed a theological synthesis of Aristotelian philosophy and Christian revelation. According to Aquinas, the all‐good Creator of the universe is the author of the moral law. In the Chronicles of Narnia, author and English professor C. S. Lewis refers to the eternal law of God as the “deep magic” that comes from the “Emperor Beyond the Sea”. (shrink)

In the academic setting as in any organization legal norms prevail and are assumed to be congruent with ethical norms. Nevertheless, there are cases when the ratio of ethical and legal norms is inadequate and disproportional, especially those dealing with socially responsible decisions in academia. For this reason, the aim here is to analyse incongruences of ethical and legal norms related to the revocation of doctoral degrees in Lithuania, illustrated with examples of deviant behaviour by academic degree holders in terms (...) of decisions of the courts and the ombudsman for academic ethics. Lithuania, being a Member State of the European Union, is currently facing the challenge of implementing newly-adopted laws related to the revocation of doctoral degrees. Accordingly, data were collected from available online official sources to gain more comprehensive evidence, and then analysed using the inductive approach of qualitative content analysis. Research findings show that there is still a thin line between ethical and legal norms, and this line fluctuates depending on nuanced considerations. This is to say that it is still problematical to dress ethical principles in legal clothing. (shrink)

In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to (...) become of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Holding Doctors Responsible at Guantánamo*Nancy Sherman (bio)I recently visited the Guantánamo Bay Detention Center with a small group of civilian psychiatrists, psychologists, top military doctors, and Department of Defense health affairs officials to discuss detainee medical and mental health care. The unspoken reason for the invitation to go on this unusual day trip was the bruising criticism the Bush administration has received for its use of psychiatrists (...) and psychologists in the interrogation of suspected terrorist detainees.1We disembarked from our Navy jet to find an island lush and green from recent storms. A small boat took us from the airfield to the naval hospital. From the boat there was no sign of Camp Delta, where the detainees are actually held. Nor was there a sign of prisons or barbed wire or the detention facility's 505 inmates.Our host was the commanding officer of Gitmo, Major General Jay W. Hood (an artillery officer by training), who had replaced Major General Geoffrey Miller, implicated in the "migration" of torture methods from Gitmo to Abu Ghraib. Dressed in fatigues, General Hood briefed us using PowerPoint. His intelligence director told us that interrogators have not used harsh "fear up" tactics—the ones designed to terrify—since 2003.We went by bus from the naval hospital to the 30-bed detainee hospital for quick briefings from a psychiatrist and a physician. Still, we were not permitted to see any detainees or hunger strikers, despite our requests. During our six hours on the ground, we had only a fleeting glimpse of a few detainees outside their cellblocks behind barbed wire and screened fences.Indeed, when I got home and saw the play "Guantánamo: Honor Bound to Defend Freedom," by Victoria Brittain and Gillian Slovo, I had the disquieting feeling that I had absorbed more about detainee life at the theater than I had from actually being at Gitmo. This only amplified my anxiety that what I had heard and seen during my VIP visit sidestepped the central moral issue of whether abuse is still occurring at Gitmo and whether health professionals are, or have been, a party to coercive interrogation. [End Page 199]The question that the Pentagon leadership has been focusing on, and which was a key subject of discussion during our day at Gitmo, is whether there is an ethical difference between using psychologists or psychiatrists on interrogation teams—what the Pentagon calls, "behavioral consultation teams," or BSCTs, pronounced "biscuit." Some in the Pentagon would like to have doctors and psychiatrists, who are bound by the Hippocratic teaching to "do no harm," be the clinicians treating detainees. Psychologists, who are not as bound by Hippocratic dicta, would consult with and advise interrogators. But this is a red herring. It is hair-splitting that detracts from the real issue of whether health professionals of any stripe can ethically be involved in interrogations that may involve coercive techniques or torture. The answer is clearly no. They should not be involved, directly or indirectly, in situations that may lead to the breach of confidential medical records; to torture or to cruel, inhumane, and degrading treatment; or to exploitation of fears or phobias. Mental health professionals simply should not be collaborating with interrogators in inflicting psychological torture.Hood said that "rapport building" was the preferred and an effective interrogation technique, but that is no guarantee that rougher tactics will not be used. The fact is that there is enormous pressure on the people at Guantánamo Bay to get good intelligence for the war on terror, and it is as easy for behavioral scientists as it is for interrogators to compromise their moral standards. Cunning and deception to extract information may be acceptable in some cases. But many people have been outraged to learn from media reports that methods developed by military psychologists to train our own troops to resist torture—the so-called "survival, evasion, resistance, and escape" methods taught at Ft. Bragg—have been "reverse engineered" at Guantánamo Bay to create coercive, psychologically manipulative interrogation techniques for use against detainees.Plato warned long ago that a doctor's skill, abstracted from good character and wisdom, is a neutral... (shrink)

Background: The knowledge of scientific dishonesty is scarce and heterogeneous. Therefore this study investigates the experiences with and the attitudes towards various forms of scientific dishonesty among PhD-students at the medical faculties of all Norwegian universities.MethodAnonymous questionnaire distributed to all post graduate students attending introductory PhD-courses at all medical faculties in Norway in 2010/2011. Descriptive statistics. Results: 189 of 262 questionnaires were returned (72.1%). 65% of the respondents had not, during the last year, heard or read about researchers who committed (...) scientific dishonesty. One respondent had experienced pressure to fabricate and to falsify data, and one had experienced pressure to plagiarize data. On average 60% of the respondents were uncertain whether their department had a written policy concerning scientific conduct. About 11% of the respondents had experienced unethical pressure concerning the order of authors during the last 12 months. 10% did not find it inappropriate to report experimental data without having conducted the experiment and 38% did not find it inappropriate to try a variety of different methods of analysis to find a statistically significant result. 13% agreed that it is acceptable to selectively omit contradictory results to expedite publication and 10% found it acceptable to falsify or fabricate data to expedite publication, if they were confident of their findings. 79% agreed that they would be willing to report misconduct to a responsible official. Conclusion: Although there is less scientific dishonesty reported in Norway than in other countries, dishonesty is not unknown to doctoral students. Some forms of scientific misconduct are considered to be acceptable by a significant minority. There was little awareness of relevant policies for scientific conduct, but a high level of willingness to report misconduct. (shrink)

This doctoral thesis within applied ethics consists of four articles together with a cover essay. All articles concern the ethics of skilled health worker emigration from under-served and resourcepoor regions, often referred to as ‘medical brain drain’. Methodologically, the thesis utilizes normative ethical theory to analyse the justifiability of temporary or long-term emigration restrictions, such as compulsory health service programmes, that are employed by developing countries with the aim of safeguarding their needs for health care provision. Such programmes restrict the (...) mobility of individual health workers and give rise to conflicts between different types of rights and interests. -/- The ethics of skilled worker emigration warrants an exploration of the ethical implications of such restrictive programmes for different stakeholders, such as the under-served countries and health workers; and a clarification of the rights and duties of the concerned parties. This thesis provides a thorough analysis and clarification of such rights restrictions and offers theoretically and empirically grounded recommendations as to how they ought to be managed. Rights theory and accounts of individual responsibilities are employed to assess the acceptability of restrictive health service programmes. -/- In brief, the thesis (a) discusses the conditions under which individual health workers may have responsibilities to attend to the basic health needs of a population, (b) explicates the rights at stake such as the freedom of movement and the right to exit, (c) offers insight into what it means to restrict one’s right and its implications and (d) suggests ways for conflicting rights and interests to be balanced and resolved. Taken together, the thesis presents a nuanced approach towards individual responsibilities in under-served contexts and an improved understanding of the right to exit as well as the implications of restricting the right. The thesis also contributes to the ethics of skilled worker emigration with a discussion on the responsibilities of skilled workers when the other parties do not fulfil their fair share of responsibilities. (shrink)

In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want‐to‐be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to (...) become of a certain type, more specifically: a person that will be the want‐to‐be parents' child. Want‐to‐be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want‐to‐be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence‐based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want‐to‐be parents is morally required and therefore also for want‐to‐be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk‐responsibility analysis. (shrink)

The debate on responsibility for health takes place within political philosophy and in policy setting. It is increasingly relevant in the context of rationing scarce resources as a substantial, and growing, proportion of diseases in high-income countries is attributable to lifestyle. Until now, empirical studies of medical professionals' attitudes towards personal responsibility for health as a component of prioritisation have been lacking. This paper explores to what extent Norwegian physicians find personal responsibility for health relevant in prioritisation (...) and what type of risk behaviour they consider relevant in such decisions. The proportion who agree that it should count varies from 17.1% to 26.9%. Higher age and being male is positively correlated with acceptance. The doctors are more willing to consider substance use in priority setting decisions than choices on food and exercise. The findings reveal that a sizeable proportion have beliefs that conflict with the norms stated in the Norwegian Patient Act. It may be possible that the implementation of legal regulations can be hindered by the opposing attitudes among doctors. A further debate on the role personal responsibility should play in priority setting seems warranted. However, given the deep controversies about the concept of health responsibility and its application, it would be wise to proceed with caution.Design Nationally representative cross-sectional study. Setting Panel-data. Participants 1072 respondents, response rate 65%. (shrink)

Background The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. Methods A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in Barbados (a (...) tertiary care teaching hospital) during April and May 2003. Results The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01) Conclusion The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them. (shrink)

In 2021, a survey was conducted among doctors and nurses at Landspítali Iceland University Hospital (LIUH) regarding their views on medical assistance in dying (MAID) and the underlying arguments, the inclusion criteria and modality of implementation. Surveys on identically defined study groups in 1995 and 2010 were used for comparison. The survey was sent to 357 doctors and 516 nurses working at LIUH. It included seven questions and several subquestions. Participants’ answers were compared by profession, age group, and (...) specialisation status. Descriptive and inferential statistics were used. A total of 135 doctors (38% response rate) and 103 nurses (20% response rate) answered the survey, representing 27% of the study group. A total of 145 (61%) participants were positive about MAID, with the most common argument being patient autonomy. The 95% margin of error for this view was ± 6.2%. Compared to 19% in 2010, support for MAID had tripled in 2021 (p < 0.05). Approximately 18% of participants did not support MAID of any kind, mostly due to arguments regarding preserving life or inconsistencies with the role of health care professionals. Finally, 19% of participants were uncertain of their views towards MAID, mostly due to the high level of complexity of the matter. Compared to previous surveys, a large increase in positive attitudes towards MAID was observed among this study population. The results revealed the reasons for participants’ attitudes; weighing patients’ dignity/autonomy against professionals’ duty to “not to kill”/palliate and showing some differences between professions. (shrink)

BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 (...) responses were obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ2=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ2=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ2=13.33, p<0.001;χ2=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ2=5.19, p<0.05;χ2=8.38, p<0.05;χ2=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ2=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ2=7.82, p<0.01;χ2=7.31, p<0.01;χ2=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ2=5.47, p<0.05).ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it. (shrink)

Little is known about the mechanisms by which psychology graduate programs transmit responsible conduct of research (RCR) values. A national sample of 968 current students and recent graduates of mission-diverse doctoral psychology programs completed a Web-based survey on their research ethics challenges, perceptions of RCR mentoring and department climate, whether they were prepared to conduct research responsibly, and whether they believed psychology as a discipline promotes scientific integrity. Research experience, mentor RCR instruction and modeling, and department RCR policies predicted student (...) RCR preparedness. Mentor RCR instruction, department RCR policies, and faculty modeling of RCR behaviors predicted confidence in the RCR integrity of the discipline. Implications for training are discussed. (shrink)

This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients’ sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty of (...) doctors and healthcare professionals is to help patients as best they can—not to judge them. Patients should not be forced into giving up any more personal information than what is strictly necessary to receive an adequate treatment, and their medical data should only be used for appropriate purposes. Medical ethics codes should reflect these data rights. When a doctor asks personal questions that are irrelevant to diagnose or treat a patient, the appropriate response from the patient is: ‘none of your business’. (shrink)

Almost any medicine can be purchased online from abroad. Many high-income countries permit individuals to import medicines for their personal use. However, those who import medicines face the risk of purchasing poor-quality products that may not work, or that may even harm them. Many people are willing to accept this risk for the opportunity to purchase more affordable medicines. This is especially true of individuals from low socioeconomic backgrounds who already struggle to afford the medicines they need if they are (...) not subsidised by insurers or if copayments are high. As medicine prices and out-of-pocket healthcare spending continue to climb, the online marketplace provides an important alternative for individuals in high-income countries to source medicines. In this article, I argue that doctors have a responsibility to help patients access medicines online and I propose a framework that can be used to facilitate responsible personal importation. (shrink)

Dr Bawa-Garba, a senior paediatric trainee who had been involved in the care of a child who died shortly after admission to hospital, was convicted of gross negligence manslaughter and subsequently erased from the medical register. We argue that criminalisation of doctors in this way is fraught with ethical tensions at levels of individual blameworthiness, systemic failures, professionalism, patient safety and at the interface of the regulator and doctor. The current response to alleged manslaughter during clinical care is not (...) fit for purpose because of its narrow focus on criminalisation and punishment of individual doctors. The justice system fails to take into account systemic issues in a sufficiently proper and informed way particularly in respect of human factors involved in decision-making. It is easier to convict individual doctors for gross negligence manslaughter than it is to effect legal accountability upon organisations. If educational reflections are used to apportion blame, then this could impact detrimentally on honesty and the duty of candour, with negative implications for patient safety. Regulatory processes should not be deployed without consideration of context. There is an urgent need for a fresh and open evaluation of professional and societal expectations from the regulator that should include positive action as well as those that are proportionately punitive. Justice and patient safety would be served better by more sophisticated contextualisation through an approach that balances accountability in healthcare with failures that can occur within complex systems, and by working to a radical shift towards a just culture. (shrink)

Some doctors do enter into sexual relationships with patients. These relationships can be damaging to the patient involved. One response available to both individual doctors and to disciplinary bodies is to prohibit sexual contact between doctors and patients ("zero tolerance"). This paper considers five ways of arguing for a zero tolerance policy. The first rests on an empirical claim that such contact is almost always harmful to the patient involved. The second is based on a "principles" approach (...) while the third originates in "virtues" ethics. The fourth argues that zero tolerance is an "a priori" truth. These four attempt to establish that the behaviour is always wrong and ought, therefore, to be prohibited. The fifth argument is counterfactual. It claims a policy that allowed sexual contact would have unacceptable consequences. Given the responsibility of regulatory bodies to protect the public, zero tolerance is a natural policy to develop. (shrink)

Background This study aimed to ask a sample of the general population about their preferences regarding doctors holding discretionary powers in relation to disclosing cancer diagnosis and prognosis. Methods The researchers mailed 443 questionnaires to registered voters in a ward of Tokyo which had a socio-demographic profile similar to greater Tokyo's average and received 246 responses (response rate 55.5%). We describe and analysed respondents' attitudes toward doctors and family members holding discretionary powers in relation to cancer diagnoses disclose. (...) Results Amongst respondents who wanted full disclosure about the diagnosis without delay, 117 (69.6 %) respondents agreed to follow the doctor's discretion, whilst 111 (66.1 %) respondents agreed to follow the family member's decision. For respondents who preferred to have the diagnosis and prognosis withheld, 59 (26.5 %) agreed to follow the doctor's decision, and 79 (35.3 %) of respondents agreed with following family member's wishes. Conclusions The greater proportion of respondents wants or permits disclosure of cancer diagnosis and prognosis. In patients who reveal negative attitudes toward being given a cancer disclosure directly, alternative options exist such as telling the family ahead of the patient or having a discussion of the cancer diagnosis with the patient together with the family. It is recommended that health professionals become more aware about the need to provide patients with their cancer diagnosis and prognosis in a variety of ways. (shrink)

In the United States, the field of bioethics has expanded over the last two decades. Several institutions offer graduate-level training at both the masters and doctoral level. However, a lack of published literature on the outcomes of doctoral training in bioethics from the perspective of graduates exists. Researchers conducted an online survey of doctoral students who had finished all doctoral requirements but their dissertation, as well as doctoral graduates, of four US-based institutions to ascertain their perspectives on a number of (...) items regarding their doctoral training and their perception of how that training prepared them for their current role in the workforce. Responses from 34 participants were assessed. Respondents had positive overall views on the utility of a bioethics doctorate and the educational training they received in their respective programs. A number of areas for improvement were identified, including better structured clinical ethics training, greater opportunities for research and publishing, and having the ability to teach during their doctoral program, as well as formal pedagogy training. Greater exposure to clinical ethics consultation during the doctoral program was associated with feeling fully prepared as a clinical ethics consultant. This is the first study to assess the perspectives of bioethics doctoral graduates and ABD students regarding the utility of a bioethics doctorate. Per the perspectives of graduates and ABD students, bioethics doctorates are important and effective to train professional bioethicists. We recommend that a few key changes to these programs’ curricula can further bolster their effectiveness. (shrink)

A discussion concerning whether to conceive Artificial Intelligence systems as responsible moral entities, also known as “artificial moral agents”, has been going on for some time. In this regard, we argue that the notion of “moral agency” is to be attributed only to humans based on their autonomy and sentience, which AI systems lack. We analyze human responsibility in the presence of AI systems in terms of meaningful control and due diligence and argue against fully automated systems in medicine. (...) With this perspective in mind, we focus on the use of AI-based diagnostic systems and shed light on the complex networks of persons, organizations and artifacts that come to be when AI systems are designed, developed, and used in medicine. We then discuss relational criteria of judgment in support of the attribution of responsibility to humans when adverse events are caused or induced by errors in AI systems. (shrink)

Burnout among health professionals is at epidemic proportions. In response, many health institutions have emphasised the importance of self-care, relying particularly on the idea that doctors who are burned out provide worse care for their patients. Although not made explicit, this suggests that doctors might have a responsibility to their patients (and perhaps others) to practice self-care. This chapter explores the potential grounds for such an obligation. We suggest that while there is potential for a limited obligation (...) of self-care, institutional emphasis on this risks instrumentalising doctors' well-being, minimising institutional responsibilities and workers' rights, and being excessively demanding for individuals. (shrink)

By comparing the role of harmony in Eryximachus’ discourse with other Platonic passages, especially from the Timaeus, this article aims to provide textual evidence concerning Plato’s conception of cosmological medicine as “harmonic techne”. The comparison with other dialogues will enable us to demonstrate how Eryximachus’ thesis is consistent with Plato’s cosmology — a cosmology which cannot be reduced to a physical conception of reality but represents the expression of a dialectical, and erotic cosmos, characterized by the agreement of parts. Arguably, (...) Eryximachus’ discourse is expression of the Platonic tendency to translate onto the philosophical plane the implications of a model peri physeos. Harmonic techne is thus always linked to the theme of moral responsibility: the philosopher is also doctor, musician and demiurges in his harmonizing activity. The speech of Eryximachus can be approached as a Platonic step which is fundamental for establishing the need for a “medicine” to cure disorder, with a view to obtaining a cosmos ordered according to the harmonic principle. (shrink)

The centrality of trust in traditional doctor–patient relationships has been criticized as inordinately paternalistic, yet in today's discussions about medical ethics—mostly in response to disruptive innovation in healthcare—trust reappears as an asset to enable empowerment. To turn away from paternalistic trust‐based doctor–patient relationships and to arrive at an empowerment‐based medical model, increasing reference is made to the importance of nurturing trust in technologies that are supposed to bring that empowerment. In this article we stimulate discussion about why the move towards (...) patient empowerment may not be able to keep clear of the criticism of trust in traditional patient–doctor relationships. First, we explore how such a shift in trust dynamics might corrode patient empowerment in the name of patient empowerment. Second, we examine how a translocation of trust may at best push the “trust issue” elsewhere and at worst make it harder to evaluate trustworthiness. (shrink)

OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether (...) the patient was described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated. (shrink)

The article addresses issues at the nexus of physician industrial action, moral agency, and responsibility. There are situations in which we find ourselves best placed to offer aid to those who may be in vulnerable positions, a behavior that is consistent with our everyday moral intuitions. In both our interpersonal relationships and social life, we make frequent judgments about whether to praise or blame someone for their actions when we determine that they should have acted to help a vulnerable (...) person. While the average person is unlikely to confront these kinds of situations often, those in the medical professions, physicians especially, may confront these and similar situations regularly. Therefore, when physicians withhold their services for whatever reason in support of industrial action, it raises issues of moral responsibility to patients who may be in a vulnerable position. Using theories of moral responsibility, vulnerability, and ethics, this paper explores the moral implications of physician industrial action. We explore issues of vulnerability of patients, as well as the moral responsibility and moral agency of doctors to patients. Determining when a person is vulnerable, and when an individual becomes a moral agent, worthy of praise or blame for an act or non-action, is at the core of the framework. Notwithstanding the right of physicians to act in their self-interest, we argue that vulnerability leads to moral obligations, that physicians are moral agents, and the imperatives of their obligations to patients clear, even if limited by certain conditions. We suggest that both doctors and governments have a collective responsibility to prevent harm to patients and present the theoretical and practical implications of the paper. (shrink)

Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire. Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine. Main outcome measure—Doctors' and nurses' attitude towards and practices of VE. Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (...) (68%). A total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. (shrink)

From the turn of the century, jurists have tended to associate lawyers with doctors as professionals and tried to ground this association in an analogy between law and medicine. Paradoxically, such comparisons suggest that American law and medicine are not analogous, while an analogy proposed by Plato illumines more fundamental respects in which law and medicine might be truly analogous.

The present volume elucidates the scope of responsibility in science and technology governance by way of assimilating insights gleaned from sociological theory and STS and by investigating the ways in which responsibility unfolds in social processes. Drawing on these theoretical perspectives, the volume goes on to review a 'heuristic model' of responsibility. Such a model provides a simple, tentative, though no less coherent analytical framework for further examining the idea of responsibility, its transformations, configurations and contradictions. (...) This concise but insightful and intellectually rich book offers a new departure in the growing corpus on responsible research and innovation. Scholars of both sociology and science and technology studies will be informed, and at times captivated, by the depth and clarity of argument provided by the authors and by its implications for the responsible governance of science and technology. Phil Macnaghten, Professor of Technology and International Development, Wageningen University, The Netherlands In this highly recommendable book, the authors make a convincing case for bringing social theory into the evolving discussion about responsibility in the context of science and technology. Their argument is stringently developed into an inspiring and promising heuristic framework for analysing responsibility. The book is a model of clarity and deserves a broad audience in science and technology studies, social theory, and beyond. Niels Mejlgaard, Centre Director, Danish Centre for Studies in Research and Research Policy, Aarhus University, Denmark Authors Simone Arnaldi is post-doctoral research fellow in sociology at the University of Padua, Italy. Luca Bianchi is adjunct professor of sociology at the University of Trieste, Italy. (shrink)

In her authoritative collection of contemporary sources on the Black Death, Rosemary Horrox subdivided the part dedicated to 'explanations and responses' in three sections: 'The religious response', 'Scientific explanation', and 'Human agency'.2 Even if there are overlaps between these categories, they offer explicit or implicit explanations of pestilence and suggest adequate responses to it in different terms. Documents in the first are centered on God's anger and punishment for human sins, those in the second on natural mechanisms not immediately dependent (...) on God's will, while those in the third on alleged conspiracies and secret machinations of the Jews. If we look at the... (shrink)