This paper documents a quantitative study into socially responsible principles and practices adopted in registered clubs in New South Wales Australia to manage one of their social impacts – problem gambling. The survey utilised an adapted version of Aupperle''s (1982) corporate social responsibility instrument to measure the priority given to economic, legal, ethical and discretionary principles in club machine gambling operations. The survey also assessed support for certain management practices in responsible gambling. The results indicate (...) that the participating club managers prioritise economic, legal, ethical and discretionary principles respectively, and that these are statistically related to practices they have implemented and support in responsible gambling. The managers most favoured secondary harm minimisation practices, followed by reactive primary intervention. Less favoured were proactive primary intervention and discretionary practices. These principles and practices contrast markedly with those advocated by key stakeholder groups, as expressed in semi-structured interviews and submissions to the NSW Gaming Inquiry. Non-industry stakeholders favoured a more balanced set of principles and a more holistic set of management practices in responsible gambling. The results also provide validation of Aupperle''s (1982) instrument when applied to corporate management of a single social impact and for Carroll''s (1979, 1991) construct of corporate social responsibility. (shrink)

Dynamic intra-individual variability (IIV) in cardiac vagal control across multiple situations is believed to contribute to adaptive cognition under stress; however, a dearth of research has empirically tested this notion. To this end, we examined 25 U.S. Army Soldiers (all male, Mean Age= 30.73, SD = 7.71) whose high-frequency heart rate variability (HF-HRV) was measured during a resting baseline and during three conditions of a shooting task (training, low stress, high stress). Response inhibition was measured as the correct rejection of (...) friendly targets during the low and high stress conditions. We tested the association between the standard deviation of HF-HRV across all four task conditions (IIV in vagal control) and changes in response inhibition between low and high stress. Greater differences in vagal control between conditions (larger IIV) were associated with higher tonic vagal control during rest, and stronger stress-related decreases in response inhibition. These results suggest that flexibility in vagal control is supported by tonic vagal control, but this flexibility also uniquely relates to adaptive cognition under stress. Findings are consistent with neurobehavioral and dynamical systems theories of vagal function. (shrink)

In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (WOC). We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions (...) that were generally accepted long before MAID was legal or considered ethical. Forgetting or misunderstanding the analyses would naturally lead one to think MAID and other end-of-life decisions are morally equivalent. Yet as we recall these well-developed analyses, it becomes clear that approving of some forms of sedation and WOC does not commit one to MAID. Paediatric patients and their families can rationally and coherently reject MAID while choosing palliative care and WOC. Finally, the authors do not substantiate their claim that MAID is like palliative care in that it alleviates suffering. It is thus unreasonable to use this supposition as a warrant for their proposed policy. (shrink)

Business Ethics, the Environment & Responsibility, Volume 31, Issue 2, Page 589-600, April 2022.

Despite significant progress in the legalization and decriminalization of abortion in Australia over the past decade or more recent research and government reports have made it clear that problems with the provision of services remain. This essay examines such issues and sets forth the view that such issues can and should be seen as (bio)ethical concerns. Whilst conscientious objection—the right to opt-out of provision on the basis of clear ethical reservations—is a legally and morally permissible stance that healthcare (...) professionals can adopt, this does not mean those working in healthcare can simply elect not to be providers absent a clear ethical rationale. Furthermore, simple non-provision would seem to contravene the basic tenants of medical professionalism as well as the oft raised claims of the healthcare professions to put the needs of patients first. Recognizing that much of the progress that has been made over the past three decades can be attributed to the efforts of dedicated healthcare professionals who have dedicated their careers to meeting the profession’s collective responsibilities in this area of women’s health and reproductive healthcare, this paper frames the matter as a collective ethical lapse on the part of healthcare professionals, the healthcare professions and those involved in the management of healthcare institutions. Whilst also acknowledging that a range of complex factors have led to the present situation, that a variety of steps need to be taken to ensure the proper delivery of services that are comprehensive, and that there has been an absence of critical commentary and analysis of this topic by bioethicists, I conclude that there is a need to (re)assess the provision of abortion in Australia at all levels of service delivery and for the healthcare professions and healthcare professionals to take lead in doing so. That this ought to be done is clearly implied by the healthcare profession’s longstanding commitment to prioritizing the needs of patient over their own interests. (shrink)

Authorship transgressions, duplicate data reporting and reporting/data errors compromise the integrity of biomedical publications. Using a standardized template, we raised concerns with journals about each of these characteristics in 33 pairs of publications originating from 15 preclinical trials reported by a group of researchers. The outcomes of interest were journal responses, including time to acknowledgement of concerns, time to decision, content of decision letter, and disposition of publications at 1 year. Authorship transgressions affected 27/36 publications. The median proportion of duplicate (...) data within pairs of publications was 45%. Data/reporting discrepancies [median 3 ] were present in 28/33 pairs. Journals acknowledged receipt of concerns for 53% and 94% of publications by 1 month and 9 months, respectively. After 1 year, journals had communicated decisions for 16/36 publications. None of the decision letters specifically addressed each of the concerns raised. Decisions were no action, correction and retraction for 9, 3 and 4 publications, respectively: the amounts of duplicate data reporting and data/reporting discrepancies were similar irrespective of journal decision. Authorship transgressions affected 6/9 publications for which no action was decided. Journal responses to concerns about duplicate publication, authorship transgressions, and data/reporting discrepancies were slow, opaque and inconsistent. (shrink)

Performance measurement has far-reaching implications for not-for-profit organizations because it serves to legitimize, attract resources, and preserve expectations of stakeholders. However, the existing theory and practice of not-for-profit performance measurement have fallen short, due in part, to an overuse of profit-oriented philosophies. Therefore, we examine not-for-profit performance measurement by utilizing Marques’ “five spiritual practices of Buddhism.” Marques’ spiritual practices—a pro-scientific philosophy, greater personal responsibility, healthy detachment, collaboration, and embracing a wholesome view—are the foundation of our research design. Responses from senior (...) not-for-profit practitioners support the linkages between spiritual practices and not-for-profit performance measurement. We identify three essential performance measurement principles and elaborate on their capacity to generate awareness, higher meaning, and connectedness within not-for-profits. (shrink)

The need for continuing provision of beneficial experimental interventions after research is concluded remains a controversial topic in bioethics for research. Based on the principle of beneficence, justice as reciprocity, concerns about exploitation and fair benefits, participants should be able to have continuing access to benefits beyond the research period. However, there is no consensus about whether or not post-trial provision of beneficial interventions should be mandatory for participants from developing countries. This paper summarises recommendations from international and (...) national guidelines. Ethical principles and practical issues relating to post-trial provision are also discussed. In conclusion, post-trial provision is not necessary in all situations and a set of criteria are proposed to identify the situations that beneficial interventions should be provided beyond the research period. However, mandatory post-trial supply of beneficial experimental interventions should be assured for those who still need and are able to benefit from them but have no alternative access. Mandatory provision is based on universal bioethical principles such as beneficence and justice. Furthermore, difficulties associated with implementation of post-trial provision are not unmanageable. Careful advanced planning and a comprehensive partnership among relevant parties would be very helpful in solving these difficulties in practice, which therefore should not be taken as an excuse to escape post-trial responsibility. (shrink)

This paper discusses so-called post-trial access to drugs for patients who participated in clinical trials in Brazil. Brazil is currently a relevant country for the pharmaceutical industry due to the dimensions of its actual and potential market. As a consequence, the number of pharmaceutical trials has been rising. It is the largest market for pharmaceutical companies in Latin America, the 8th biggest in the world and second only to China among the so-called BRICS’s emerging countries. The demand for pharmaceutical products (...) in the country has been increasing by double digits over the last few years, reaching 20% in 2008. Not surprisingly, we are also witnessing a steady increase in the number of applications by national and international pharmaceutical companies before ethical research authorities for authorization to perform clinical trials of drugs. (shrink)

With the previous technical reports, we presented the main insights from the qualitative analysis of the reflection of the mathematical dimension of gambling in gambling-related sites, in its structural, linguistic, epistemic, and informative aspects. In this report we will focus on the factors responsible for the patterns that the content of the gambling-related sites exhibit and the way that the mathematical dimension of gambling is reflected in this content, namely the factors that influence the content (...) policies of these sites. The report will also point to further directions of research-for both this project and for other investigators-for finding the appropriate balance and relation between the commercial policies on the one hand, and the adequacy and ethics of the content on the other hand. (shrink)

The current report presents results of the qualitative analysis of the usage of the key math terms in the content of the reviewed websites in the current sample, with emphasis on the necessary distinctions for the word and concept of ‘odds’. Patterns, motivations, conceptual and contextual aspects of the usage are discussed. The theoretical norms of adequacy of this usage in the context of gambling are briefly presented. -/- Technical report of the research project 'Reflection of the mathematical dimension (...) of gambling in iGaming online content - A qualitative analysis'. (shrink)

The objective of this paper is to examine the responsible gambling (RG) disclosure strategies employed by four Nordic state‐owned gambling companies, each selling products with addictive potential. RG disclosures are used by the gambling industry to proclaim responsibility and interest in gambling harm. Data drawn from company annual reports underwent qualitative content analysis. The analysis based on categories established by Leung and Snell in 2021 revealed four disclosure strategies: assertive façade, defensive façade, disclaiming, and ethical (...) reflexivity. All companies employed an assertive strategy, offering detailed accounts of their RG measures, including initiatives such as care calls to customers. The companies often adopted a defensive strategy, characterized by vague and generalizing language in describing their RG activities. Three companies occasionally adopted a disclamation strategy, presenting RG as a cost. Ethical reflexivity, which involves acknowledging responsibility for gambling harm, was a disclosure strategy seldom chosen by the companies. Although variations exist in the disclosure strategies among the companies, overall, the companies strived to project a positive image. The conclusion suggests that endorsing RG as a legitimate harm prevention approach may mask the inherent conflicts of interest between gambling companies and advocates of harm prevention. (shrink)

In light of the observations and research design presented in the previous reports, the current technical report is focused on the relationship between the quality and specificity of the content of the gambling sites and the site’s SEO and marketing policy. This relationship is dependent upon the category of the gambling site and the difference in content quality, and the degree to which the mathematical dimension of gambling is reflected in this content is explained by this dependence.

Background: This article describes the types of community-wide benefits provided by investigators conducting public health research in South Asia as well as their self-reported reasons for providing such benefits. Methods: We conducted 52 in-depth interviews to explore how public health investigators in low-resource settings make decisions about the delivery of ancillary care to research subjects. In 39 of the interviews respondents described providing benefits to members of the community in which they conducted their study. We returned to our narrative dataset (...) to find answers to two questions: What types of community-wide benefits do researchers provide when conducting public health intervention studies in the community setting, and what reasons do researchers give when asked why they provided community-wide benefits? Findings: The types of community-wide benefits delivered were directed to the health and well-being of the population. The most common types of benefits delivered were the facilitation of access to health care for individuals in acute medical need and emergency response to natural disasters. Respondents' self-reported reasons when asked why they provided such benefits fell into 2 general categories: intrinsic importance and instrumental importance. (shrink)

The current technical report presents the partial results of the quantitative analysis of the research project, after the review of 247 gambling websites. It is focused on and discusses the usage of the math terms specific to gambling in the reviewed sample. In particular, the fifth technical report discusses the usage of math terms associated with the game of slots, as found in the reviewed sample.

Time-limited trials of intensive care have arisen in response to the increasing demand for intensive care treatment for patients with a low chance of surviving their critical illness, and the clinical uncertainty inherent in intensive care decision-making. Intensive care treatment is reported by most patients to be a significantly unpleasant experience. Therefore, patients who do not survive intensive care treatment are exposed to a negative dying experience. Time-limited trials of intensive care treatment in patients with a low chance of surviving (...) have both a small chance of benefiting this patient group and a high chance of harming them by depriving them of a good death. A ‘rule of rescue’ for the critically unwell does not justify time-limiting a trial of intensive care treatment and overlooks the experiential costs that intensive care patients face. Offering time-limited trials of intensive care to all patients, regardless of their chance of survival, overlooks the responsibility of resource-limited intensive care clinicians for suffering caused by their actions. A patient-specific risk–benefit analysis is vital when deciding whether to offer intensive care treatment, to ensure that time-limited trials of intensive care are not undertaken for patients who have a much higher chance of being harmed, rather than benefited by the treatment. The virtue ethics concept of human flourishing has the potential to offer additional ethical guidance to resource-limited clinicians facing these complex decisions, involving the balancing of a quantifiable survival benefit against the qualitative suffering that intensive care treatment may cause. (shrink)

Although long touted as an ethical and legal requirement, some clinicians still seem to offer less than fully adequate informed consent processes; similarly the counseling of patients and families, particularly about post-intervention scenarios, is often perfunctory at best. Keyed to a narrative of a patient's experience with surgery for a deviated septum, this article reflects on why such less than adequate clinician behaviors tend to occur and what might be done about them. Certain legal misconceptions about informed consent are highlighted (...) in this reflection, as well as why certain clinicians seem to take such a narrow view of their responsibilities to patients. Further reference in this regard is also made to a recently constructed module on informed consent for medical residents. In it, though legal requirements for informed consent are reviewed, the basic perspective taken regards informed consent as a clinical intervention that pursues certain basic goods and values, only one of which lies in determining when legal closure for such processes has occurred. (shrink)

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the (...) daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

The Japanese government and medical professionals have negative attitudes toward the provision of prenatal testing and related information due to social concern regarding discrimination against persons with disabilities. However, with the rapid increase in the number of non-invasive prenatal tests, particularly at non-certificated medical facilities, in response to the growing demand from pregnant women, the Japanese government and medical professional associations have enacted radical changes marking an active commitment to the provision of information on these services. While a (...) major justification for these policy changes is to ensure respect for reproductive autonomy and women’s self-determination, they may reinforce the concern regarding discrimination. This article investigated the argument that these new policies may reinforce discrimination and examined three objections to this argument. The results revealed that the recent policy changes, particularly for specific fetal traits, may imply a negative belief about people living with the same traits. Consequently, fundamental institutional changes are necessary. (shrink)

Philosophical and sociological approaches in technology have increasingly shifted toward describing AI (artificial intelligence) systems as ‘(moral) agents,’ while also attributing ‘agency’ to them. It is only in this way – so their principal argument goes – that the effects of technological components in a complex human-computer interaction can be understood sufficiently in phenomenological-descriptive and ethical-normative respects. By contrast, this article aims to demonstrate that an explanatory model only achieves a descriptively and normatively satisfactory result if the concepts of ‘(moral) (...) agent’ and ‘(moral) agency’ are exclusively related to human agents. Initially, the division between symbolic and sub-symbolic AI, the black box character of (deep) machine learning, and the complex relationship network in the provision and application of machine learning are outlined. Next, the ontological and action-theoretical basic assumptions of an ‘agency’ attribution regarding both the current teleology-naturalism debate and the explanatory model of actor network theory are examined. On this basis, the technical-philosophical approaches of Luciano Floridi, Deborah G. Johnson, and Peter-Paul Verbeek will all be critically discussed. Despite their different approaches, they tend to fully integrate computational behavior into their concept of ‘(moral) agency.’ By contrast, this essay recommends distinguishing conceptually between the different entities, causalities, and relationships in a human-computer interaction, arguing that this is the only way to do justice to both human responsibility and the moral significance and causality of computational behavior. (shrink)

Randomness, a core concept of gambling, is seen in problem gambling as responsible for the formation of the math-related cognitive distortions, especially the Gambler’s Fallacy. In problem-gambling research, the concept of randomness was traditionally referred to as having a mathematical nature and categorized and approached as such. Randomness is not a mathematical concept, and I argue that its weak mathematical dimension is not decisive at all for the randomness-related issues in gambling and problem gambling, (...) including the correction of the misconceptions and fallacies about probability and statistical concepts applied in gambling. I distinguish between mathematical and nonmathematical dimensions of randomness (the epistemic, the theoretical-methodological, the functional, and the ethical) falling within the general concept, and I argue that both the studies having as object the math-related cognitive distortions among gamblers and the educational programs aiming at correcting them should employ this distinction in their design and content. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

Online gambling companies claim that they are ethical providers. They seem committed to corporate social responsibility (CSR) practices that are aimed at preventing or minimising the harm associated with their activities. Our empirical research employed a sample of 209 university student online gamblers, who took part in an online survey. Our findings suggest that the extent of online problem gambling is substantial and that it adversely impacts on the gambler's mental and physical health, social relationships and academic performance. (...) Online problem gambling seems to be related to the time spent on the Internet and gambling online, parental/peer gambling and binge drinking. As our findings show that there are harmful repercussions associated with online gambling, we argue that companies in this controversial sector cannot reach the higher level of CSR achieved by other industries. Nevertheless, they can gain legitimacy on the basis of their CSR engagement at a transactional level, and so, by meeting their legal and ethical commitments and behaving with transparency and fairness, the integrity of the company can be ensured. We also argue that current failures in the implementation and control of CSR policies, the reliance on revenue from problem gamblers' losses, and controversial marketing activities appear to constitute the main obstacles in the prevention or minimisation of harm related to online gambling. As online gambling companies must be responsible for the harm related to their activities, we suggest that CSR policies should be fully implemented, monitored and clearly reported; all forms of advertising should be reduced substantially; and unfair or misleading promotional techniques should be banned. The industry should not rely on revenue from problem gamblers, nor should their behaviour be reinforced by marketing activities (i.e. rewards). We realise, however, that it is unrealistic to expect the online gambling industry to prioritise harm prevention over revenue maximisation. Policy makers and regulators, therefore, would need to become involved if the actions suggested above are to be undertaken. CSR is paramount to minimise harm and provide a healthier user experience in this business sector, but it also poses marketing dilemmas. We support a global collaborative approach for the online gambling industry, as harm related to gambling is a public health issue. (shrink)

Objective—To identify and describe the current state of clinical ethics support services in the UK.Design—A series of questionnaire surveys of key individuals in National Health Service (NHS) trusts, health authorities, health boards, local research ethics committees and health professional organisations. Interviews with chairmen/women of clinical ethics committees identified in the surveys.Setting—The UK National Health Service.Results—Responses to the questionnaires were received from all but one NHS trust and all but one health authority/board. A variety of models of clinical ethics support were (...) identified including twenty formal clinical ethics committees (CECs). A further twenty NHS trusts expressed an intention to establish a CEC within the next twelve months. Most CECs in the UK have been in existence less than five years and are still defining their role. The chairmen identified education of committee members and contact with other ethics committees as important requirements for committee development. Problems were identified around lack of support for the committee and with raising the profile of the committee within the institution. There has been little evaluation of clinical ethics support services either in the UK or in other countries with longer established services. What evaluation has occurred has focused on process rather than outcome measures.Conclusions—Clinical ethics support services are developing in the UK. A number of issues have been identified that need to be addressed if such support services are to develop effectively. (shrink)

When pandemics hit communities, women are bound to suffer as most of the responsibilities of ensuring food security lie on them. This article assesses the impact of the COVID-19 pandemic on the role that church-going women play in food provision. The qualitative study used interviews and focus group discussions to examine the toll of the pandemic-induced restrictions, especially with regard to their disruption of activities that ensure the provision of food for the family. They sought to identify how (...) an environment as restrictive as the one that was imposed during the COVID-19 pandemic affects those largely responsible for food provision in urban Marondera – the women, in this case. The focus was extended to factor in how disasters and pandemics affect women and detract from their normative food procurement and provision roles in marginal societies and how these effects can be mitigated to allow women to carry on with their roles even in restrictive environments. This research was motivated by the recent COVID-19-imposed regulations that restricted the movement of people, restrictions that have only recently been relaxed and (in some cases) removed. We also sought to establish how gender roles are played out, together with whether they are exacerbated by pandemics, and in what ways these pandemics result in higher workloads on women. By utilising the Africana womanist theory, the study analysed women roles in food provision and food security in their societies within the restrictive environments of the pandemics.Contribution: This study concluded that there are gender inequalities that are exacerbated by these pandemics that result in higher workloads for women. It foregrounded how existing gender inequalities were exacerbated by the pandemic, resulting in higher workloads on women. It therefore recommended that women should form empowerment groups to help focus attention on food provision to mitigate challenges women face in this role. Finally, we averred that there ought to be consultation and participation of women on issues to do with pandemics to allow for their full and productive participation in critical roles of providing food. (shrink)

On the question of whether gambling behavior can be changed as result of teaching gamblers the mathematics of gambling, past studies have yielded contradictory results, and a clear conclusion has not yet been drawn. In this paper, I bring some criticisms to the empirical studies that tended to answer no to this hypothesis, regarding the sampling and laboratory testing, and I argue that an optimal mathematical scholastic intervention with the objective of preventing problem gambling is possible, by (...) providing the principles that would optimize the structure and content of the teaching module. Given the ethical aspects of the exposure of mathematical facts behind games of chance, and starting from the slots case – where the parametric design is missing, we have to draw a line between ethical and optional information with respect to the mathematical content provided by a scholastic intervention. Arguing for the role of mathematics in problem-gambling prevention and treatment, interdisciplinary research directions are drawn toward implementing an optimal mathematical module in cognitive therapies. (shrink)

In this article I reject the claim that the responsibilities acquired by gamete providers can be transferred to their biological children's intending parents. I defend this position by first showing that arguments in defence of the transferability of responsibilities in gamete provision cases fail to distinguish between the transfer and delegation of responsibility. I then provide an argument against the transferability of responsibilities in gamete provision cases that differs from the ones offered by James Lindemann Nelson and Rivka (...) Weinberg. Though I conclude that gamete providers have inalienable responsibilities towards their biological offspring, I note that the precise ethical and policy implications this has for gamete provision remain somewhat unclear. (shrink)

This paper draws on the ethics of care to investigate how citizens grappled with ethical tensions in the mundane practice of grocery shopping at the height of the Covid-19 pandemic. We use this case to address the broader question of what it means ‘to care’ in the context of a crisis. Based on a qualitative longitudinal cross-country interview study, we find that the pandemic transformed ordinary shopping spaces into places fraught with a sense of fear and vulnerability. Being forced to (...) face one’s own vulnerability created an opportunity for individuals to relate to one another as significant others through a sense of “response-ability”, or the capacity of people to respond to ethical demands through situated ethical reasoning. We argue for a practical ethos of care in which seemingly small decisions such as how often to go shopping and how much to buy of a particular product serve as a means to relate to both specified and generalized others—and through this, ‘care with’ society. Our study contributes to displacing the continuing prevalence of an abstract and prescriptive morality in consumption ethics with a situated and affective politics of care. This vocabulary seems better suited to reflect on the myriad of small and unheroic care acts in times of crisis and beyond. (shrink)

While there is a great deal to agree with in the essay Expanded Terminal Sedation in End-of-Life Care there is, we think, a need to more fully appreciate the humanistic side of both palliative and end-of-life care.1 Not only does the underlying philosophy of palliative care arguably differ from that which guides curative medicine,2 dying patients are in a uniquely vulnerable position given our cultural disinclination towards open discussions of death and dying. In this brief response, we critically engage Gilbertson (...) et al ’s essay and seek to contextualise the perspective they put forward. According to Cassell, we should distinguish between pain and suffering.3 The former often gives rise to the latter, but suffering has other causes. This includes existential distress, indicating that, unlike pain, suffering is not simply physiological phenomena. Suffering involves the disintegration of the person, meaning that it can impact patient autonomy. Certainly, that a patient is suffering does not equate to a lack autonomy. Nevertheless, we should take care when making decisions in circumstance where the integrity of our embodied personhood is under threat, something that is clearly the case for those who are dying, particularly those who have refractory symptoms while doing so. Generally speaking, refractory symptoms are those which are intractable. They persist despite attempts at palliation. While this implies that such symptoms—and the suffering they cause—cannot be reversed this is not necessarily the case. Not only can the symptoms experienced by dying patients change …. (shrink)

Understanding the interconnectedness of the gambling harms is essential for developing comprehensive strategies to mitigate the damage caused by problem gambling. Central to this effort is the concept of playing informed. The current review synthesizes current research on the cascading harms in relation to the critical role of informed gambling in the reduction of these harms, while pointing out interdisciplinary connections that might contribute to this research for crystallizing an adequate conceptual and theoretical framework.

Mobile applications and socio-sexual networking websites are used by outreach workers to respond synchronously to questions and provide information, resources, and referrals on sexual health and STI/HIV prevention, testing, and care to gay, bisexual and other men who have sex with men. This exploratory study examined ethical issues identified by online outreach workers who conduct online sexual health outreach for GB2M. Semi-structured individual interviews were conducted between November 2013 and April 2014 with online providers and managers to explore the benefits, (...) challenges, and ethical implications of delivering online outreach services in Ontario, Canada. Interviews were digitally recorded and transcribed verbatim. Thematic analyses were conducted, and member-checking, analyses by multiple coders, and peer debriefing supported validity and reliability. Four themes emerged on the ethical queries of providing online sexual health outreach for GB2M: managing personal and professional boundaries with clients; disclosing personal or identifiable information to clients; maintaining client confidentiality and anonymity; and security and data storage measures of online information. Participants illustrated familiarity with potential ethical challenges, and discussed ways in which they seek to mitigate and prevent ethical conflict. Implications of this analysis for outreach workers, researchers, bioethicists, and policy-makers are to: understand ethical complexities associated with online HIV prevention and outreach for GB2M; foster dialogue to recognize and address potential ethical conflict; and identify competencies and skills to mitigate risk and promote responsive and accessible online HIV outreach. (shrink)

The Iowa Gambling Task (IGT) and the Soochow Gambling Task (SGT) are two experience-based risky decision-making tasks for examining decision-making deficits in clinical populations. Several cognitive models, including the expectancy-valence learning model (EVL) and the prospect valence learning model (PVL), have been developed to disentangle the motivational, cognitive, and response processes underlying the explicit choices in these tasks. The purpose of the current study was to develop an improved model that can fit empirical data better than the EVL (...) and PVL models and, in addition, produce more consistent parameter estimates across the IGT and SGT. Twenty-six opiate users (mean age 34.23; SD 8.79) and 27 control participants (mean age 35; SD 10.44) completed both tasks. Eighteen cognitive models varying in evaluation, updating, and choice rules were fit to individual data and their performances were compared to that of a statistical baseline model to find a best fitting model. The results showed that the model combining the prospect utility function treating gains and losses separately, the decay-reinforcement updating rule, and the trial-independent choice rule performed the best in both tasks. Furthermore, the winning model produced more consistent individual parameter estimates across the two tasks than any of the other models. (shrink)

This paper investigates the time it takes unconscious vs. conscious knowledge to form by using an improved “no-loss gambling” method to measure awareness of knowing. Subjects could either bet on a transparently random process or on their grammaticality judgment in an artificial grammar learning task. A conflict in the literature is resolved concerning whether unconscious rather than conscious knowledge is especially fast or slow to form. When guessing , accuracy was above chance and RTs were longer than when feeling (...) confident . In a second experiment, short response deadlines only interfered with the quality of confident decisions . When people are unaware of their knowledge, externally enforced decisions can be made rapidly with little decline in quality; but if given ample time, they await a metacognitive process to complete. The dissociation validates no-loss gambling as a measure of conscious awareness. (shrink)

Introduction Numerous guidelines and policies for ethical research practice have evolved over time, how this translates to global health practice in resource-constrained settings is unclear. The purpose of this paper is to describe how the concept of ancillary care has evolved over time and how it is included in the ethics guidelines and policy documents that guide the conduct of research in the global south with both an international focus and providing a specific example of Malawi, where the first author (...) lives and works, as a case study. Methods Discourse analysis was conducted on 34 international ethics guidelines and policy documents. Documents were purposively selected if they contained a set of key terms that reflect the concept of ancillary care. Following a process of inductive discourse analysis, five key interrelated text phrases relating to ancillary care were extracted from the documents. The evolution of these phrases over time was explored as they represented the development of the concept of ancillary care as a component of ethical health research guidance and practice. Results We found key interrelated phrases that represent discourses regarding the evolution of ancillary care including participant protection; provide care as appropriate; supererogation; patient needs prevail over science; and ancillary care as an obligation. Arguments for the provision of ancillary care were characterised by safeguarding the safety, health rights and well-being of study participants. However, despite the evolution of discourse around ethical obligations to provide ancillary care, this is rarely made explicit within guidance documents, leaving interpretive space for differential application in practice. Conclusion While there have been major changes to the ethics guidance that reflect significant evolution in the ethical conduct of research, the specific vocabulary or language used to explain the ethics of researchers' ancillary care obligations to the health needs of their research participants, lacks clarity and consistency. As a result, the concept of ancillary care continues to be under-represented in local ethical guidelines and regulations, with no clear directives for country-level research ethics committees to apply in regulating ancillary care responsibilities. (shrink)

Informed by evidence from past studies and experiences with epidemics, an intervention combining quarantine, lockdowns, curfews, social distancing, and washing of hands has been adopted as “international best practice” in COVID-19 response. With massive total lockdowns complemented by electronic surveillance, China successfully controlled the pandemic in country within a few months. But would this work for Africa and other communalistic resource-poor settings where social togetherness translates to effective sharing of basic needs? What ethical and practical challenges would this pose? How (...) would communalism be translated in special contexts to be useful in contributing to the ultimate common good? This paper uses examples from the current situation of COVID-19 in Kenya to address these questions. (shrink)

It is widely accepted that overcoming the social-ecological crises we face requires major changes to the food system. However, opinions diverge on the question whether those ‘great efforts’ towards sustainability require systemic changes or merely systematic ones. Drawing upon Brand and Wissen’s concept of “imperial modes of living”, we ask whether the lively debates about sustainability and ‘ethical’ consumption among producers and consumers in Germany are far reaching enough to sufficiently reduce the imperial weight on the environment and other human (...) and nonhuman animals. By combining discourse analysis of agri-food businesses’ sustainability reports with narrative consumer interviews, we examine understandings of sustainability in discourses concerning responsible food provision and shed light on how those discourses are inscribed in consumers’ everyday food practices. We adopt Ehgartner’s discursive frames of ‘consumer sovereignty’, ‘economic rationality’, and ‘stewardship’ to illustrate our findings, and add a fourth one of ‘legitimacy’. Constituting the conditions under which food-related themes become sustainability issues, these frames help businesses to individualise the responsibility to enact changes, tie efforts towards sustainability to financial profits, subject people and nature to the combination of care and control, and convey legitimacy through scientific authority. We discuss how these frames, mirrored in some consumer narratives, work to sideline deeper engagement with ecological sustainability and social justice, and how they brush aside the desires of some ostensibly ‘sovereign’ consumers to overcome imperial modes of food provision through much more far reaching, systemic changes. Finally, we reflect on possible paths towards a de-imperialised food system. (shrink)

Minorities who disagree with the “scientific consensus” must be allowed to air their viewsI will begin by discussing the example used in Schüklenk’s paper1 of the self proclaimed “HIV dissidents” and then discuss whether the recommendations made are useful and could be applied to other examples in science.Schüklenk’s primary concern according to his title is with the professional responsibilities of biomedical scientists engaging in public discourse. The example given is of the effect that self proclaimed HIV dissidents have had on (...) the provision of HIV related public health measures in South Africa. Fundamental to the example given is a distinction that both Schüklenk and indeed the general public often fail to make. It is important to recognise the difference between biomedical science and clinical practice. Science and medicine are two distinct fields, each with their own historically founded methods and purposes; they have had little in common with each other until relatively recently. Schüklenk confuses the two when he judges a scientific hypothesis by its clinical utility."It certainly seemed prudent to me at the time to give support to critics of a hypothesis, the pursuit of which had done little to bring those in need closer to life extending or life saving AIDS drugs."He later reconsiders his position on the basis of new clinical evidence."My own conversion to the mainstream view took place roughly when dissident predictions about AIDS deaths resulting from what they believed were highly poisonous drug cocktails—that is, triple therapy, did not occur, and when it became clear that actually the opposite was true; these drugs were at least life extending. I saw … ". (shrink)

This study investigates the performance of psychopathic individuals on tasks believed to be sensitive to dorsolateral prefrontal and orbitofrontal cortex (OFC) functioning. Psychopathic and non-psychopathic individuals, as defined by the Hare psychopathy checklist revised (PCL-R) [Hare, The Hare psychopathy checklist revised, Toronto, Ontario: Multi-Health Systems, 1991] completed a gambling task [Cognition 50 (1994) 7] and the intradimensional/extradimensional (ID/ED) shift task [Nature 380 (1996) 69]. On the gambling task, psychopathic participants showed a global tendency to choose disadvantageously. Specifically, they (...) showed an impaired ability to show learning over the course of the task. On the ID/ED task, the performance of psychopathic individuals was not significantly different from incarcerated controls on attentional set-shifting, but significant impairments were found on response reversal. These results are interpreted with reference to an OFC and amygdala dysfunction explanation of psychopathy. (shrink)

This study investigates how firms in the gambling industry manage their corporate social disclosures about controversial issues. We performed thematic content analysis of CSDs about responsible gambling, money laundering prevention and environmental protection in the annual reports and stand-alone CSR reports of four USA-based multinational gambling firms and their four Macao counterparts. This study draws on impression management theory, camouflage theory and corporate integrity theory to examine the gambling firms’ CSDs. We infer that the CSD (...) strategies of gambling firms in Macao and the USA did not serve as vehicles for reflexivity about social responsibility or social responsiveness. Instead, the firms camouflaged legitimacy gaps about sensitive topics by adopting assertive or defensive façades, disclaiming ethical responsibility, curtailing disclosure, or offering zero disclosure. Differences between CSD strategies according to topic, location, time, and reporting channel appear to reflect four factors: pressure to report, availability of good news, whether a firm was assuming ethical responsibility for addressing the topic, and the prospective readership. This study extends our understanding of the contextual and topic-specific factors affecting the quantity and character of CSDs by firms in a contested industry. (shrink)

Because of the importance of board members’ resource provision and monitoring, a substantial body of research has been devoted to ascertaining how directors can be incented to perform their responsibilities. We use social exchange theory to empirically examine how board members’ resource provision and monitoring are affected by their perceptions of the CEOs’ trustworthiness. Our findings suggest that board members’ perceptions of the CEO’s ability, benevolence, and integrity have different effects on the board members’ resource provision and (...) monitoring. Our results further suggest that board members’ governance behaviors are moderated by the board’s performance evaluation practices. (shrink)

Silvia Castellazzi shows how companies can implement their corporate responsibility and support employability and access to training in an incentive-compatible manner. The study provides insights into unrealized cooperation and disincentives which prevent companies from investing in a shared pool of employable and skilled people. The research draws on the theoretical framework of the economic ethics and on in-depth interviews with key stakeholders in two European countries. Findings show that incentives for investments in training are selective and might reinforce path-dependencies and (...) exclusion, while not supporting cooperation and productive competition. The study also shows the value of conceptualizing employability as a social rather than a psychological contract to facilitate investments and the implementation of corporate responsibility. Contents Trends and Conflicts in Employability and Provision of Training Incentives Structures and Stakeholders' Strategies A Social Contract for Employability Target Groups Researchers in business ethics, employee relations, further education and training HR and training managers; CSR managers The Author Silvia Castellazzi works as account manager in the corporate education division of MIP Graduate School of Business (Politecnico di Milano). Her research interests and activities are focused on professional and executive education, corporate responsibility and decision-making, the future of work and new forms of work organization. (shrink)