International non-governmental organisations face a dilemma when deciding whether to intervene in crisis situations where their efforts can be exploited or co-opted by others: intervene and risk becoming complicit with wrongdoing or sit on the sidelines and consign vulnerable people to the ravages of neglect or oppression. In “‘He who helps the guilty, shares the crime’? INGOs, moral narcissism and complicity in wrongdoing,” Buth et al argue that concerns about complicity often stifle ethical debate and encourage moral narcissism. We argue (...) that neglecting concerns about complicity can foster a different form of moral narcissism and that where worries of complicity are present, aid efforts face three types of risk: risks to others created by contributing to wrongful acts or bad outcomes; risks to the moral integrity of the INGO and its personnel; and risks to social trust in the INGO. In the end, we challenge the assumption that there is a unique, ethically best way to reconcile these values. We suggest that the causes of justice and humanity might be better served by a diverse community of INGOs who each gives different weight to these concerns, than if each INGO adopts the same framework for reconciling these competing demands. (shrink)

Infectious disease outbreaks in residential care are complex to manage and difficult to control. Research in this setting that includes individuals who lack capacity must conform to national legislation. We report here on our study that is investigating outbreaks of scabies, an itchy skin infection, in the residential care setting in the southeast of England. There appears to be a gap in legislative advice regarding the inclusion of people who lack capacity in research that takes place during time-limited acute scenarios (...) such as outbreaks. We received inconsistent advice from experts regarding, in particular, the role of nominated consultees. There is a potential inequality for vulnerable populations who cannot themselves provide informed consent in terms of their access to participation in a range of health-related research. (shrink)

This thesis is about toleration as a modality of citizenship for pluralistic societies. Its central argument is that the current dissatisfaction with "mere" toleration which we find so broadly represented in our public and scholarly cultures is based on an underestimation of the capacities and attitudes that toleration entails. The liberal recasting of toleration, sophisticated and indeed invaluable though it is abets this devaluation by focusing too exclusively on public justification and on the Lockean stream of the tradition from which (...) we draw. ;The present thesis begins by tracing some of the difficulties facing the Rawlsian and Habermasian projects if we accept a vivid picture of the pluralisms amidst which we live. It then sketches the central features of a complementary tradition of toleration as it flows to us through the works of Montaigne, William James, Mikhail Bakhtin and others. An attempt is made to show where the resources drawn from this tradition might fit in to a theory of citizenship given reasonable Rawlsian qualms about "thick" public conceptions and given the fissiparous nature of a civil society like ours. The thesis ends with a pair of empirically oriented chapters which show ways in which we could conceive a praxis of toleration which might respond to the issues raised in the earlier sections of the work. (shrink)

Purpose: We sought to examine the ethical, legal, and social implications (ELSI) literature research and scholarship types, topics, and contributing community fields of training as a first step to charting the broader ELSI community’s future priorities and goals. Methods: We categorized 642 articles and book chapters meeting inclusion criteria for content in both human genetics or genomics and ethics or ELSI during a 5-year period (2003–2008) according to research and scholarship types, topics, and the area of advanced training of the (...) first-listed author. Research and scholarship type categories were developed and characterized through in-depth review of 95 randomly sampled publications from the larger group. Results: There is a single dominant approach to ELSI, which focuses on ethical and other social issues “downstream” of advances in genomics, the contributors to which predominately have advanced training in medicine or science fields other than social science. A comparatively low percentage of publications primarily offer policy recommendations, and these are much more likely to be written by those with advanced training in law than is the case for the literature as a whole. Social science studies predominately employ qualitative methods and vary significantly with respect to the extent and types of recommendations offered. Two further types of ELSI research and scholarship offer alternative models for so-called “normative” work in this field. Conclusion: Considering topics, training, and types of ELSI research and scholarship from the most recent past allows for a baseline perspective that is sorely needed in charting this field’s future course. (shrink)

Background: Discussion of the influence of money on bioethics research seems particularly salient in the context of research on the ethical, legal, and social implications (ELSI) of human genomics, as this research may be financially supported by the ELSI Research Program. Empirical evidence regarding the funding of ELSI research and where such research is disseminated, in relation to the specific topics of the research and methods used, can help to further discussions regarding the appropriate influence of specific institutions and institutional (...) contexts on ELSI and other bioethics research agendas. Methods: We reviewed 642 ELSI publications (appearing between 2003 and 2008) for reported sources of funding, forum for dissemination, empirical and nonempirical methods, and topics of investigation. Results: Most ELSI research is independent of direct grant-based funding sources; 66% reported no such sources of funding. The National Human Genome Research Institute (NHGRI) is the most dominant source of funding; 16% of publications acknowledged at least one source of NHGRI grant funding. Funding is acknowledged more frequently in empirical than nonempirical publications and more frequently in publications in public health journals than in any other ELSI research dissemination forums. Dominant research topics vary by publication forum and by reported funding. Conclusions: ELSI research is surprisingly independent of direct grant-based funding, yet correlations are apparent between this type of funding and publication placement, topics addressed, and methods used, implying a not insignificant influence on ELSI research agenda setting. However, given the relatively low percentage of publications acknowledging external grant-based funding, as well as other significant correlations between publication placement and topics addressed, additional institutional contexts, perhaps related to professional advancement or valuation, may shape research agendas in ways that potentially exceed the direct influences of grant-based funding in this area. In some cases, grant-based funding may actually counter other potentially problematic institutional influences. (shrink)

on writing prescriptions.[2] These two reasons indicate why there are obvious repercussions for those who do not have reasonable access to physicians’ services. Of course, the word ‘reasonable’ is important here. After all, there is the old joke—for those who enjoy gallows humor—that the U.S. has universal access to healthcare so long as one is willing to commit a crime to see the county jail’s physician, or make one’s self sick enough to qualify for emergency services. Putting aside such extraordinary (...) measures, at least some deficit in accessing physicians’ services can be made up through consulting written medical knowledge. Many libraries have medical textbooks, and the Internet has many good sites that contain medical knowledge. Of course, all the knowledge in the world is not going to do much good if treatment requires a prescription. The physicians’ monopoly on writing prescriptions means that nothing (legal[3]) can be done in terms of treatment if one does not have access to the services of a qualified physician. This state of affairs is unjust. A just society cannot have it both ways: legislation cannot say both that the expertise of physicians is so precious that only they can prescribe medicine AND not everyone is guaranteed reasonable access to their services. If there is no guarantee of reasonable access then physicians should not have a monopoly on writing prescriptions, and if there is a monopoly on writing prescriptions then people should have reasonable access to their services. (shrink)

During active vision, the eyes continually scan the visual environment using saccadic scanning movements. This target article presents an information processing model for the control of these movements, with some close parallels to established physiological processes in the oculomotor system. Two separate pathways are concerned with the spatial and the temporal programming of the movement. In the temporal pathway there is spatially distributed coding and the saccade target is selected from a Both pathways descend through a hierarchy of levels, the (...) lower ones operating automatically. Visual onsets have automatic access to the eye control system via the lower levels. Various centres in each pathway are interconnected via reciprocal inhibition. The model accounts for a number of well-established phenomena in target-elicited saccades: the gap effect, express saccades, the remote distractor effect, and the global effect. High-level control of the pathways in tasks such as visual search and reading is discussed; it operates through spatial selection and search selection, which generally combine in an automated way. The model is examined in relation to data from patients with unilateral neglect. (shrink)

Evidence in medicine can come from more or less trustworthy sources and be produced by more or less reliable methods, and its interpretation can be disputed. As such, it can be unclear when disagreements in medicine result from different, but reasonable, interpretations of the available evidence and when they result from unreasonable refusals to consider legitimate evidence. In this article, we seek to show how assessments of the relevance and implications of evidence are typically affected by factors beyond that evidence (...) itself, such as our beliefs about the credibility of the speaker or source of the evidence. In evaluating evidence, there is thus a need for reflective awareness about why we accept or dismiss particular claims. (shrink)

Human cognition and behavior are dominated by symbol use. This paper examines the social learning strategies that give rise to symbolic communication. Experiment 1 contrasts an individual-level account, based on observational learning and cognitive bias, with an inter-individual account, based on social coordinative learning. Participants played a referential communication game in which they tried to communicate a range of recurring meanings to a partner by drawing, but without using their conventional language. Individual-level learning, via observation and cognitive bias, was sufficient (...) to produce signs that became increasingly effective, efficient, and shared over games. However, breaking a referential precedent eliminated these benefits. The most effective, most efficient, and most shared signs arose when participants could directly interact with their partner, indicating that social coordinative learning is important to the creation of shared symbols. Experiment 2 investigated the contribution of two distinct aspects of social interaction: behavior alignment and concurrent partner feedback. Each played a complementary role in the creation of shared symbols: Behavior alignment primarily drove communication effectiveness, and partner feedback primarily drove the efficiency of the evolved signs. In conclusion, inter-individual social coordinative learning is important to the evolution of effective, efficient, and shared symbols. (shrink)

Available from UMI in association with The British Library. Requires signed TDF. ;The study critically examines the meaning of the statement 'Marxism-Leninism is Soviet ideology' with a view to clarifying our understanding of Marxism-Leninism. This involves an interpretative investigation of both the words 'Marxism-Leninism' and 'ideology' from the Soviet and Soviet studies perspectives, and from broader philosophical and linguistic perspectives. The resulting analysis is unique in Soviet studies insofar as it engages in a meta-critique of terms which are conventionally taken (...) for granted by Sovietologists, and insofar as it introduces a new methodological approach to the study of Marxism-Leninism. ;Its central arguments and principal conclusions are as follows: First, it is argued that ideology is a term with multiple referents but an inescapably epistemological connotation which render it incapable of conceptualization. Consequently any attempt to employ the term in the analysis of alien discourse inevitably produces both epistemological imperialism and epistemological and referential confusion which reduces that discourse itself to silence. It is therefore concluded that the term must be abandoned for the purposes of analysis. ;Secondly, it is argued that Marxism-Leninism is an empty signifier which is subject to definition on a contemporary basis by the CPSU itself. A discursive analysis of CPSU discourse demonstrates that Marxism-Leninism is in fact the central element in a mechanism of control which bears all the features of a classic double bind. It is therefore concluded that while Marxism-Leninism is referentially open to re-definition it is connotatively attached to the practices of the CPSU. It is both fixed and not fixed in meaning. This phenomenon explains many of the paradoxes in CPSU discourse that Sovietologists have been unable to explain. ;The study concludes by suggesting that this type of interpretative discursive approach is much more fruitful than the epistemology critique which has been conventionally employed. (shrink)

In this paper, we outline a framework for understanding the different kinds of knowledge required for medical practice and use this framework to show how scientism undermines aspects of this knowledge. The framework is based on Michael Polanyi’s claim that knowledge is primarily the product of the contemplations and convictions of persons and yet at the same time carries a sense of universality because it grasps at reality. Building on Polanyi’s ideas, we propose that knowledge can be described along two (...) intersecting “dimensions”: the tacit–explicit and the particular–general. These dimensions supersede the familiar “objective−subjective” dichotomy, as they more accurately describe the relationship between medical science and medical practice. Scientism, we argue, excludes tacit and particular knowledge and thereby distorts “clinical reality” and impairs medical practice and medical ethics. (shrink)

Sovereignty in premodern times evoked the dynastic figure of the 'sovereign' or territorial monarch. In modern times, it became a more abstract idea, referring to the power of the state, later of the people or 'the popular sovereign' as articulated and refined through constitutional arrangements. Today these inherited understandings of sovereignty confront various new challenges, including those of globalization, privatization of power, and the rise of sub-state nationalism. An examination of key historical writers and trends from the seventeenth century onwards, (...) including Hobbes, Bodin, Constant, Rousseau and Schmitt, brings out these developments and challenges. Sovereignty remains a malleable and 'active' feature of the global configuration of power. Will sovereignty become a redundant concept over time, or will it remain a key part of the grammar of modern politics? (shrink)