Walter Savage Landor's exasperated marginal comment on line 13 of Horace, C. 1. 4 has sent modern commentators scurrying to the poem's defence. The skirmish has been won for Horace, but at the expense perhaps of magnifying the importance of line 13: A. Y. Campbell insisted that pallida mors, far from being irrelevant, was ‘the focus of the whole poem’.

A self-fulfilling prophecy in neuroprognostication occurs when a patient in coma is predicted to have a poor outcome, and life-sustaining treatment is withdrawn on the basis of that prediction, thus directly bringing about a poor outcome for that patient. In contrast to the predominant emphasis in the bioethics literature, we look beyond the moral issues raised by the possibility that an erroneous prediction might lead to the death of a patient who otherwise would have lived. Instead, we focus on the (...) problematic epistemic consequences of neuroprognostic SFPs in settings where research and practice intersect. When this sort of SFP occurs, the problem is that physicians and researchers are never in a position to notice whether their original prognosis was correct or incorrect, since the patient dies anyway. Thus, SFPs keep us from discerning false positives from true positives, inhibiting proper assessment of novel prognostic tests. This epistemic problem of SFPs thus impedes learning, but ethical obligations of patient care make it difficult to avoid SFPs. We then show how the impediment to catching false positive indicators of poor outcome distorts research on novel techniques for neuroprognostication, allowing biases to persist in prognostic tests. We finally highlight a particular risk that a precautionary bias towards early withdrawal of life-sustaining treatment may be amplified. We conclude with guidelines about how researchers can mitigate the epistemic problems of SFPs, to achieve more responsible innovation of neuroprognostication for patients in coma. (shrink)

Largely due to the cultural and political shift of the Enlightenment, Western societies in the eighteenth century emerged from sectarian conflict and embraced a more religiously moderate path. In nine original essays, leading scholars ask whether exporting the Enlightenment solution is possible—or even desirable—today. Contributors begin by revisiting the Enlightenment's restructuring of the West, examining its ongoing encounters with Protestant and Catholic Christianity, Judaism, Islam, and Hinduism. While acknowledging the necessity of the Enlightenment emphasis on toleration and peaceful religious coexistence, (...) these scholars nevertheless have grave misgivings about the Enlightenment's spiritually thin secularism. The authors ultimately upend both the claim that the West's experience offers a ready-made template for the world to follow and the belief that the West's achievements are to be ignored, despised, or discarded. (shrink)

George Yancy gathers white scholarship that dwells on the experience of whiteness as a problem without sidestepping the question’s implications for Black people or people of color. This unprecedented reversion of the “Black problem” narrative challenges contemporary rhetoric of a color-evasive world in a critically engaging and persuasive study.

Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity (...) if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 vaccination policies among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This ‘conditional’ policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large. (shrink)

Rapid growth in structural and functional brain research has led to increasing ethical discussion of what to do about incidental findings within the brains of healthy neuroimaging research participants that have potential health importance, but which are beyond the original aims of the study. This dilemma has been widely debated with respect to general neuroimaging research but has attracted little attention in the context of neuromarketing studies. In this paper, I argue that neuromarketing researchers owe participants the same ethical obligations (...) as other neuroimaging researchers. The financial resources available to neuromarketing firms and the social value of neuromarketing studies should command greater attention to the elucidation and management of incidental findings. However, this needs to be balanced against finite resources available within most public health systems. (shrink)

Research Ethics, Volume 18, Issue 2, Page 151-162, April 2022. In today’s online data-driven world, people constantly shed data and deposit digital footprints. When individuals access health services, governments and health providers collect and store large volumes of health information about people that can later be retrieved, linked and analysed for research purposes. This can lead to new discoveries in medicine and healthcare. In addition, when securely stored and de-identified, the privacy risks are minimal and manageable. In many jurisdictions, ethics (...) committees routinely waive the requirement for researchers to obtain consent from data subjects before using and linking these datasets in an effort to balance respect for individuals with research efficiency. In this paper, I explore the ethical justification for using routinely collected health data for research without consent. I conclude that, not only is this morally justified but also that data subjects have a moral obligation to contribute their data to such research, which would obviate the need for ethics committees to consider consent waivers. In justifying this argument, I look to the duty of easy rescue, distributive justice and draw analogies with vaccination ethics. (shrink)

This valuable book will give educators solution-based methods and research-based resources to improve classroom culture, as well as enabling schools to elevate students' engagement and academic achievement.

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 121.3 (2000) 385-407 [Access article in PDF] Plautus' Stichus and the Political Crisis of 200 B.C. William M. Owens What to make of Stichus? Scholars have written appreciatively of its separate parts: the sisters who are loyal wives to their absent husbands, the sympathetic depiction of the parasite Gelasimus, and even the wild celebration of the slaves that ends the play. 1 However, when considering (...) Stichus as an artistic whole, scholarship has tended to blanket the play with anathema. Thus Norwood: "What of Stichus, which falls into three mere lumps?" 2 Duckworth is more discursive but no less disparaging: "The Stichus is hardly a drama; there is no real plot and complication and denouement of the usual sort are lacking. The scenes fall into three groups: these might be called 'The Abandoned Wives' (1-401), 'The Homecoming, or the Disappointed Parasite' (402-640), and 'The Carousal of the Slaves' (641-775)." 3Previous readings have focused on the relation of Stichus to Plautus' model, Menander's first Adelphoe, attributing the deficiencies in the Roman play to Plautine departures from the model, either through free invention of scenes and characters or through contaminatio, the introduction of scenes from Greek plays other than Adelphoe. 4 However, even those who believe that Plautus was more or less faithfully following the contents of Menander's Adelphoe consider Stichus to be a poorly constructed work. 5Given this general critical disparagement and the almost complete [End Page 385] loss of its model, source criticism of Stichus has come to resemble a kind of philological shadowboxing against an invisible and superior opponent. The present reading seeks to understand the difficulties of this play in terms of its Roman audience of 200 B.C. The broad outlines of this approach were developed by Segal in Roman Laughter (1987), who argued that Plautine humor was accommodated to Roman concerns and preoccupations. Wagenvoort (1931) anticipated Segal's approach with specific reference to Stichus in his suggestion that the play reflects the jubilant mood of the people who had defeated Hannibal in the previous year and recently celebrated Scipio's triumph. Such a people, he argued, were in no mood for a play constructed by the book, but wanted one that was accommodated to their mood: Plautus Stichum [composuit]... cum etiam atque etiam aliae aliunde copiae domum reverterentur, isdem fortasse diebus, quibus summo cum gaudio Romani Scipionem aspicerent triumphantem. Tali tempore non id profecto cives a poeta suo poposcerunt, ut comoediam sibi praeberet rigidis normis adstrictam quodque ad compositionem attinet omnibus numeris absolutam, sed ut spectaculum sibi offerret ad commune gaudium quam poterat maxime accommodatum. 6There is evidence that Stichus was matched to the mood of its audience; the Ludi Plebeii for which the play was produced in 200 B.C. were repeated three times, and the popularity of Stichus may have been one of the reasons for the multiple instaurationes. 7 However, the mood of the people of Rome in 200 B.C., a politically turbulent year, was more complex than summum et commune gaudium. Fresh upon the victory [End Page 386] over Hannibal, the Senate was preparing to fight a war in Greece against Philip V of Macedon. Since the autumn of 201 senatorial ambassadors had been sent to various Greek states to canvass support for Roman intervention; during this same period ambassadors from a number of Greek states had been in Rome to complain about Philip's aggressions. 8 In March 200 the consul P. Sulpicius Galba, having received Macedonia as his province, proposed a declaration of war against Philip to the Centuriate Assembly. But a tribune, Q. Baebius, spoke against the bill, and war was rejected by nearly every voting division (ab omnibus ferme centuriis antiquata est, Liv. 31.6.3). Livy reports that the people were exhausted from the length of the war they had just completed and that Baebius was able to exploit their discontent.In response, the Senate advised Galba to try again. The war was approved after a vigorous speech from the consul. Livy does... (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Context The attitudes of medical professionals towards physician assisted dying have been widely discussed. Less explored is the level of agreement among physicians on the possibility of ‘rational suicide’—a considered suicide act made by a sound mind and a precondition of assisted dying legislation. Objective To assess attitudes towards rational suicide in a representative sample of senior doctors in England and Wales. Methods A postal survey was conducted of 1000 consultants and general practitioners randomly selected from a commercially available database. (...) The main outcome of interest was level of agreement with a statement about rational suicide. Results The corrected participation rate was 50%; 363 questionnaires were analysed. Overall 72% of doctors agreed with the possibility of rational suicide, 17% disagreed, and 11% were neutral. Doctors who identified themselves as being more religious were more likely to disagree. Some doctors who disagreed with legalisation of physician assisted suicide nevertheless agreed with the concept of rational suicide. Conclusions Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

It has been forty years since the first multi-channel cochlear implant was used in Australia. While heralded in the hearing world as one of the greatest inventions in modern medicine, not everyone reflects on this achievement with enthusiasm. For many people in the Deaf community, they see the cochlear implant as a tool that reinforces a social construct that pathologizes deafness and removes Deaf identity. In this paper, I set out the main arguments for and against cochlear implantation. While I (...) conclude that, on balance, cochlear implants improve the well-being and broaden the open futures of deaf children, this does not justify mandating implants in circumstances where parents refuse them because this may compound unintended harms when society interferes in the parent-child relationship. For this reason, I argue that parental refusal of cochlear implantation falls within Gillam’s concept of the zone of parental discretion. (shrink)

Idiopathic Parkinson’s disease impairs working memory, but the exact nature of this deficit in terms of the underlying cognitive mechanisms is not well understood. In this study patients with mild clinical symptoms of PD were compared with matched healthy control subjects on a computerized battery of tests designed to assess spatial working memory and verbal working memory. In the spatial working memory task, subjects were required to recall a sequence of four locations. The verbal working memory task was methodologically identical (...) except for the modality of the stimuli used, requiring subjects to orally recall a sequence of six digits. In either case, half of the sequences were structured in a way that allowed ‘chunking’, while others were unstructured. This manipulation was designed to dissociate the strategic component of task performance from the memory-load component. Mild medicated patients with PD were impaired only on the structured versions of the verbal working memory tasks. The analogous deficit in the spatial working memory was less pronounced. These findings are in agreement with the hypothesis that working memory deficits in PD reflect mainly the executive component of the tasks and that the deficits may be at least partly modality-independent. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

Environmental ethicists have frequently criticized ancient Greek philosophy as anti-environmental for a view of philosophy that is counterproductive to environmental ethics and a view of the world that puts nature at the disposal of people. This provocative collection of original essays reexamines the views of nature and ecology found in the thought of Plato, Aristotle, the Stoics, and Plotinus. Recognizing that these thinkers were not confronted with the environmental degradation that threatens contemporary philosophers, the contributors to this book find that (...) the Greeks nevertheless provide an excellent foundation for a sound theory of environmentalism. (shrink)

Recently developed super‐resolution microscopy techniques are changing our understanding of lipid rafts and membrane organisation in general. The lipid raft hypothesis postulates that cholesterol can drive the formation of ordered domains within the plasma membrane of cells, which may serve as platforms for cell signalling and membrane trafficking. There is now a wealth of evidence for these domains. However, their study has hitherto been hampered by the resolution limit of optical microscopy, making the definition of their properties problematic and contentious. (...) New microscopy techniques circumvent the resolution limit and, for the first time, allow the fluorescence imaging of structures on length scales below 200 nm. This review describes such techniques, particularly as applied to the study of membrane organisation, synthesising newly emerging facets of lipid raft biology into a state‐of‐the art model.Editor's suggested further reading in BioEssays: Super‐resolution imaging prompts re‐thinking of cell biology mechanisms Abstract and Quantitative analysis of photoactivated localization microscopy (PALM) datasets using pair‐correlation analysis Abstract. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Can dreams reveal insight into our cognitive abilities and aptitudes (i.e., “human intelligence”)? The relationship between dream production and trait-like cognitive abilities is the foundation of several long-standing theories on the neurocognitive and cognitive-psychological basis of dreaming. However, direct experimental evidence is sparse and remains contentious. On the other hand, recent research has provided compelling evidence demonstrating a link between dream content and new learning, suggesting that dreams reflect memory processing during sleep. It remains to be investigated whether the extent (...) of learning-related dream incorporation (i.e., the semantic similarity between waking experiences and dream content) is related to inter-individual differences in cognitive abilities. The relationship between pre–post sleep memory performance improvements and learning-related dream incorporation was investigated ( N = 24) to determine if this relationship could be explained by inter-individual differences in intellectual abilities (e.g., reasoning, short term memory (STM), and verbal abilities). The extent of dream incorporation using a novel and objective method of dream content analysis, employed a computational linguistic approach to measure the semantic relatedness between verbal reports describing the experience on a spatial (e.g., maze navigation) or a motor memory task (e.g., tennis simulator) with subsequent hypnagogic reverie dream reports and waking “daydream” reports, obtained during a daytime nap opportunity. Consistent with previous studies, the extent to which something new was learned was related ( r = 0.47) to how richly these novel experiences were incorporated into the content of dreams. This was significant for early (the first 4 dream reports) but not late dreams (the last 4 dream reports). Notably, here, we show for the first time that the extent of this incorporation for early dreams was related ( r = 0.41) to inter-individual differences in reasoning abilities. On the other hand, late dream incorporation was related ( r = 0.46) to inter-individual differences in verbal abilities. There was no relationship between performance improvements and intellectual abilities, and thus, inter-individual differences in cognitive abilities did not mediate the relationship between performance improvements and dream incorporation; suggesting a direct relationship between reasoning abilities and dream incorporation. This study provides the first evidence that learning-related dream production is related to inter-individual differences in cognitive abilities. (shrink)

In an era of transition and tension in American health care, Dorothy M. Owens offers a model of empathic communication that benefits both patients and physicians. Drawing from concepts in the domains of psychology and theology, she constructs a model of empathy that is ethical and reciprocal. An integrated model of empathy, she argues, recognizes the physical, psychological, spiritual, and social nature of human beings. empathy is a clinically useful, time effective communication skill that can be taught in medical education.

The assessment of decision-making capacity in patients with brain injuries presents a range of clinical and legal challenges. Existing guidance on the conduct of such assessments is often generic; guidance specific to patients with brain injury is sparse and coarse-grained. We report on an interview-based study of decision-making capacity in patients suffering from acquired brain injury and organic personality disorder. We identify challenges associated with the assessment of DMC in this patient population, review three bodies of relevant research from cognitive (...) neuropsychology and neurophysiology, and draw on phenomenological analysis to identify three distinct abilities that play a role in decision-making, but which can be compromised in patients with organic personality disorder. We address the challenge of translating clinical findings into legally attestable results. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

This study aimed to develop a valid and reliable performance analysis template for quantifying team action variables in elite men’s wheelchair basketball. First action variables and operational definitions were identified by the authors and verified by an expert panel of wheelchair basketball coaching staff in order to establish expert validity. A total of 109 action variable were then placed into 17 agreed Categorical Predictor Variable categories. The action variables were then used to develop a computerized performance analysis template for post-event (...) analysis. Each possession (n = 200) from an international men’s wheelchair basketball game was analyzed by the first author on two occasions for assessment of intra-observer reliability and by a coach and a performance analyst for inter-observer reliability. Percentage error and Weighted Kappa coefficients were calculated to compare the levels of error and agreement for each action variable. Intra-observer reliability demonstrated perfect or almost perfect agreement (. (shrink)

Clinical mental health researchers may understandably struggle with how to incorporate biological assessments in clinical research. The options are numerous and are described in a vast and complex body of literature. Here we provide guidelines to assist mental health researchers seeking to include biological measures in their studies. Apart from a focus on behavioral outcomes as measured via interviews or questionnaires, we advocate for a focus on biological pathways in clinical trials and epidemiological studies that may help clarify pathophysiology and (...) mechanisms of action, delineate biological subgroups of participants, mediate treatment effects, and inform personalized treatment strategies. With this paper we aim to bridge the gap between clinical and biological mental health research by (1) discussing the clinical relevance, measurement reliability, and feasibility of relevant peripheral biomarkers; (2) addressing five types of biological tissues, namely blood, saliva, urine, stool and hair; and (3) providing information on how to control sources of measurement variability. (shrink)

Rapid technological advances have produced a variety of novel techniques that allow a comprehensive assessment of brain function to be combined with detailed information about brain structure and connectivity. Any assessment that is based on exhibited behavior after brain injury will be prone to error for a number of reasons. These questions are explored in the context of recent studies in both healthy populations and brain injured patients that have sought to investigate covert awareness through the use of functional neuroimaging. (...) Those circumstances in which functional magnetic resonance imaging data can be used to infer awareness in the absence of a behavioral response are contrasted with those circumstances in which it cannot. This distinction is fundamental for understanding and interpreting patterns of brain activity following acute brain injury and has implications for clinical care, diagnosis, prognosis, and medicolegal decision-making after serious brain injury. (shrink)

Conversion therapy refers to a range of unscientific, discredited and harmful heterosexist practices that attempt to re-align an individual’s sexual orientation, usually from non-heterosexual to heterosexual. In Australia, the state of Victoria recently joined Queensland and the Australian Capital Territory in criminalising conversion therapy. Although many other jurisdictions have also introduced legislation banning conversion therapy, it persists in over 60 countries. Children are particularly vulnerable to the harmful effects of conversion therapy, which can include coercion, rejection, isolation and blame. However, (...) if new biotechnologies create safe and effective conversion therapies, the question posed here is whether it would ever be morally permissible to use them. In addressing this question, we need to closely examine the individual’s circumstances and the prevailing social context in which conversion therapy is employed. I argue that, even in a sexually unjust world, conversion therapy may be morally permissible if it were the only safe and effective means of relieving intense anguish and dysphoria for the individual. The person providing the conversion therapy must be qualified, sufficiently independent from any religious organisation and must provide conversion therapy in a way that is positively affirming of the individual and their existing sexuality. (shrink)

:Recent neuroimaging research on disorders of consciousness provides direct evidence of covert consciousness otherwise not detected clinically in a subset of severely brain-injured patients. These findings have motivated strategic development of binary communication paradigms, from which researchers interpret voluntary modulations in brain activity to glean information about patients’ residual cognitive functions and emotions. The discovery of such responsiveness raises ethical and legal issues concerning the exercise of autonomy and capacity for decisionmaking on matters such as healthcare, involvement in research, and (...) end of life. These advances have generated demands for access to the technology against a complex background of continued scientific advancement, questions about just allocation of healthcare resources, and unresolved legal issues. Interviews with professionals whose work is relevant to patients with disorders of consciousness reveal priorities concerning further basic research, legal and policy issues, and clinical considerations. (shrink)

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

The “happiness agenda” is a worldwide movement that claims that happiness is the highest good, happiness can be measured, and public policy should promote happiness. Against Happiness is a thorough and powerful critique of this program, revealing the flaws of its concept of happiness and advocating a renewed focus on equality and justice. Written by an interdisciplinary team of authors, this book provides both theoretical and empirical analysis of the limitations of the happiness agenda. The authors emphasize that this movement (...) draws on a parochial, Western-centric philosophical basis and demographic sample. They show that happiness defined as subjective satisfaction or a surplus of positive emotions bears little resemblance to the richer and more nuanced concepts of the good life found in many world traditions. Cross-cultural philosophy, comparative theology, and social and cultural psychology all teach that cultures and subcultures vary in how much value they place on life satisfaction or feeling happy. Furthermore, the ideas promoted by the happiness agenda can compete with rights, justice, sustainability, and equality—and even conceal racial and gender injustice. Against Happiness argues that a better way forward requires integration of cross-cultural philosophical, ethical, and political thought with critical social science. Ultimately, the authors contend, happiness should be a secondary goal—worth pursuing only if it is contingent on the demands of justice. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)