Biomedical research is an increasingly multidisciplinary activity bringing together a range of different academic fields and forms of expertise to investigate diseases that are increasingly understood to be complex and multifactorial. Recently the discipline of ethics has been starting to find a place in large-scale biomedical collaborations. In this article we draw from our experience of working with the Malaria Genomic Epidemiology Network and other research projects to reflect upon the integration of ethics into biomedical research. We examine the way (...) in which ethics input may be valuable to research, the forms it tends to take, and also the problems and limitations of such collaborations. (shrink)

Over the last 300 years science has been quite successful at revealing the nature of physical reality. In so doing it has provided an epistemological basis for scientific discovery and technological innovation. But science has been decidedly less successful at guiding political debate. How do we conceive of the science-society relation in the 21st century? How does scientific research hook onto the world in a multi-faceted, pluralistic, and global age? This essay seeks to reframe our thinking about the broader impacts (...) of science by awakening an appreciation of the inescapably political and dimension of all knowledge, scientific or otherwise. (shrink)

Implementation of guidelines regarding breaches of electronic health information requires an anticipatory stance and physician and patient education regarding security and monitoring measures and methods of redress. Adopting a preventive ethics, rather than a crisis management, model may also increase physician awareness of how the information they choose to include and privilege within the health record may expose patients to added harms if not done mindfully.

This paper traces the unspoken, implicit white racial logic of the brain disease model of addiction, which is based on seemingly universal, disembodied brains devoid of social or environmental influences. In the United States, this implicit white logic led to “context-free” neuroscience that made the social hierarchies of addiction and its consequences invisible to, and thus exacerbated by, national policies on opioids. The brain disease model of addiction was selectively deployed among the white middle-class population that had long accessed narcotics (...) and pharmaceutical treatments for narcotics disorders from biomedical clinics, as opposed to from illegal sources subject to law enforcement. In turn, new treatments for opioid addiction were racially marketed to the same white clientele to which newly patented opioid analgesics were marketed, tapping into a circumscribed but highly lucrative consumer base that has long benefited from a legally protected, racially segregated safe space for white narcotics consumption. The connecting thread for the contemporary white opioid “crisis,” therefore, is white race as a ghost variable in addiction neuroscience and in its pharmaceutical and biotechnological translation. (shrink)

Research on corporate sustainability has started to acknowledge the role of temporality in creating more sustainable organizations. Yet, these advances tend to treat firms as monolithic and we have little understanding of how different temporal patterns throughout an organization shape perceptions of and actions toward sustainability. Building on studies highlighting how the temporal structures of work shape employee engagement with different organizational processes and issues, we seek to answer: How does the temporality of work practices structure perceptions of corporate sustainability (...) throughout the firm? Using data from an ethnography of a small European sustainable bank, we provide an account of the variety of ways in which employees in different departments perceive the bank and how they engage with sustainability. We then go on to show how the temporal structures of work practices within different departments help explain some divergence in perceptions of sustainability. Our study highlights the variegation of temporal structures in organizational processes of meaning-making and its role for a better understanding of the efforts to make corporations more sustainable. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

This article questions the meanings and expression of "citizenship" in the context of new Latina and Latino migration into the southeastern United States-a region long marked by legally policed racial systems and now experiencing the varied shocks of globalization. Focused on a legislative campaign that won access to a state-issued driver's licence for undocumented migrants in Tennessee in spring 2001, the article explores some of the tensions that emerged on the road to this unlikely victory and raises questions for the (...) immigrants' rights movement in the US about the costs and gains that may follow from different ways of framing its demands. The dominant frame this particular campaign adopted was a pragmatic and politically acceptable call to improve traffic safety, one that reflected a conscious choice to downplay issues of rights, justice or global perspective. Yet the article also reports that the campaign in fact created and used opportunities for activists to raise issues related to migrant rights. It also made a dramatic, albeit temporary, improvement in the daily lives of migrants in the state. The article then sketches three citizenship norms that current struggles might prefigure. These three norms are: the full right to international mobility of human beings; the right to identity; and duties of citizenship in a globalizing world. (shrink)

A comprehensive and systematic reconstruction of the philosophy of Charles S. Peirce, perhaps America's most far-ranging and original philosopher, which reveals the unity of his complex and influential body of thought. We are still in the early stages of understanding the thought of C. S. Peirce (1839-1914). Although much good work has been done in isolated areas, relatively little considers the Peircean system as a whole. Peirce made it his life's work to construct a scientifically sophisticated and logically rigorous philosophical (...) system, culminating in a realist epistemology and a metaphysical theory ("synechism") that postulates the connectedness of all things in a universal evolutionary process. In The Continuity of Peirce's Thought, Kelly Parker shows how the principle of continuity functions in phenomenology and semeiotics, the two most novel and important of Peirce's philosophical sciences, which mediate between mathematics and metaphysics. Parker argues that Peirce's concept of continuity is the central organizing theme of the entire Peircean philosophical corpus. He explains how Peirce's unique conception of the mathematical continuum shapes the broad sweep of his thought, extending from mathematics to metaphysics and in religion. He thus provides a convenient and useful overview of Peirce's philosophical system, situating it within the history of ideas and mapping interconnections among the diverse areas of Peirce's work. This challenging yet helpful book adopts an innovative approach to achieve the ambitious goal of more fully understanding the interrelationship of all the elements in the entire corpus of Peirce's writings. Given Peirce's importance in fields ranging from philosophy to mathematics to literary and cultural studies, this new book should appeal to all who seek a fuller, unified understanding of the career and overarching contributions of Peirce, one of the key figures in the American philosophical tradition. (shrink)

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)

This volume aims to contextualize the development and reception of Husserl’s transcendental-phenomenological idealism by placing him in dialogue with his most important interlocutors – his mentors, peers, and students. Husserl’s “turn” to idealism and the ensuing reaction to Ideas I resulted in a schism between the early members of the phenomenological movement. The division between the realist and the transcendental phenomenologists is often portrayed as a sharp one, with the realists naively and dogmatically rejecting all of Husserl’s written work after (...) the Logical Investigations. However, this understanding of the trajectory of the phenomenological movement ignores the extensive and intricate contours of the idealism-realism debate. In addition to helping us better interpret Husserl’s attempts to defend his idealism, reconsidering the idealism-realism debate elucidates the relationship and differences between Husserl's phenomenology and the broader landscape of early 20th century German philosophy, particularly the Munich phenomenologists and the Neo-Kantians. The contributions to this volume reconsider many of the early interpretations and critiques of Husserl, inviting readers to assess the merits of the arguments put forward by his critics while also shedding new light on their so-called “misunderstandings” of his idealism. This text should be of interest to researchers working in the history of phenomenology and Husserlian studies. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

Currently, humans lack the cognitive and moral capacities to prevent the widespread suffering associated with collective risks, like pandemics, climate change, or even asteroids. In Moral Enhancement and the Public Good, Parker Crutchfield argues for the controversial, and initially counterintuitive claim that everyone should be administered a substance that makes us better people. Furthermore, he argues that it should be administered without our knowledge. That is, moral bioenhancement should be both compulsory and covert. Crutchfield demonstrates how our duty to (...) future generations and our epistemic inability to promote the public good highlight the need for compulsory, covert moral bioenhancement. This not only gives us the best chance of preventing widespread suffering, compared to other interventions (or doing nothing), it also best promotes liberty, autonomy, and equality. In a final chapter, Crutchfield addresses the most salient objections to his argument. (shrink)

Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics (...) revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health. (shrink)

There is a need for all industries, including healthcare, to reduce their greenhouse gas emissions. In anaesthetic practice, this not only requires a reduction in resource use and waste, but also a shift away from inhaled anaesthetic gases and towards alternatives with a lower carbon footprint. As inhalational anaesthesia produces greenhouse gas emissions at the point of use, achieving sustainable anaesthetic practice involves individual practitioner behaviour change. However, changing the practice of healthcare professionals raises potential ethical issues. The purpose of (...) this paper is twofold. First, we discuss what moral duties anaesthetic practitioners have when it comes to practices that impact the environment. We argue that behaviour change among practitioners to align with certain moral responsibilities must be supplemented with an account of institutional duties to support this. In other words, we argue that institutions and those in power have second-order responsibilities to ensure that practitioners can fulfil their first-order responsibilities to practice more sustainably. The second goal of the paper is to consider not just the nature of second-order responsibilities but the content. We assess four different ways that second-order responsibilities might be fulfilled within healthcare systems: removing certain anaesthetic agents, seeking consensus, education and methods from behavioural economics. We argue that, while each of these are a necessary part of the picture, some interventions like nudges have considerable advantages. (shrink)

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA (...) tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process. (shrink)

In our paper ‘The ethical case for non-directed postmortem sperm donation’ we argued that it would be ethical for men to donate sperm after death for use by strangers. In their thoughtful response Fredrick and Ben Kroon lay out practical concerns regarding our proposal. They raise issues regarding the quality of sperm collected postmortem based on empirical studies. Second, they claim that concerns about quality would make women unlikely to use sperm collected after death. In this response we explore issues (...) of sperm quality in both living and dead donors. We consider whether there might be ways to ensure quality in both. Finally, we question whether quality should be a barrier to women choosing to use sperm donated after death. (shrink)

Brummett and Salter propose a useful and timely taxonomy of clinical ethics expertise (2019). As the field becomes further “professionalized” this taxonomy is important, and the core of it is right. It needs some refinement around the edges, however. In their conclusion, Brummett and Salter rightly point out that there is a significant difference between the ethicist whose recommendations are procedure- and process-heavy, consensus-driven, and dialogical and the authoritarian ethicist whose recommendations flow from “private moral views” (Brummett and Salter, 2019). (...) This admission doesn’t go far enough. Brummett and Salter’s taxonomy fails to capture the notion that offering recommendations whose normative force is moral is different in kind from recommendations whose normative force is non-moral, such as those recommendations that are free of moral content or justified by convention. The difference is in kind, not scale. I argue further that clinical ethics expertise, if possible, consists at least in offering recommendations whose normative force is moral. These two claims imply that the taxonomy fails to cut clinical ethics expertise at the joints: the ethicist who offers justified non-moral normative recommendations is a different kind of ethicist from the one who offers justified moral normative recommendations, yet both are categorized as clinical ethics experts. I finish by offering a refinement of the taxonomy that more precisely categorizes clinical ethicists. (shrink)

Conceptual clarity is essential when engaging in dialogue to avoid unnecessary disagreement and to promote mutual understanding. In this issue devoted to clinical bioethics, the authors exemplify the virtue of careful conceptual analysis as they explore complex clinical questions regarding the essential nature of medicine, the boundaries of killing and letting die, the meaning of irreversibility in definitions of death, the argument for a right to try experimental medications, the ethical borders in complex medical billing, and the definition and modeling (...) of complex disease states. (shrink)

The National Health Service (NHS) was the first healthcare system globally to declare ambitions to become net carbon zero. To achieve this, a shift away from metered-dose inhalers which contain powerful greenhouse gases is necessary. Many patients can use dry powder inhalers which do not contain greenhouse gases and are equally effective at managing respiratory disease. This paper discusses the ethical issues that arise as the NHS attempts to mitigate climate change. Two ethical issues that pose a barrier to moving (...) away from metered-dose inhalers are considered: patients who decline an inhaler with a smaller carbon footprint and increased cost. I argue that while a patient is not morally justified in refusing a more environmentally sustainable inhaler due to the expected harms, a doctor may still prescribe a metered-dose inhaler if they believe that switching without consent might undermine trust or substantially worsen the patient’s health. Turning to cost, I argue that the imperative to combat climate change means the NHS should accept small increased financial costs for lower carbon inhalers, even though this provides no additional direct benefit for the patient. I then go on to consider the implications of the preceding analysis for policy and practice. I argue for a policy that minimises the impact of inhalers on the climate by advocating for a principle of environmental prescribing and explore decision-making in practice. While the arguments here pertain primarily to inhalers, the discussion has broader implications for debates around healthcare’s responsibility to be environmentally sustainable. (shrink)

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

This is a book about two stories of education. In one story there is a vocabulary of means, efficiency, bureaucracy, inspection and science; in the other, one of autonomy, democracy, emancipation and action research. One is the story of positivist managerialist approaches to education, the other is the story of reflective teaching. This book displaces both of these stories. By applying the techniques of deconstruction, Stuart Parker overturns the assumptions common to both of these positions and, in doing so, (...) jettisons some widely cherished beliefs about education, autonomy and rationality. Moving beyond current debates, this book articulates a new manifesto for education in postmodernity and highlights the implications for educational practices and institutions. (shrink)

Philosophers continue to debate both the actual and the ideal roles of values in science. Recently, Eric Winsberg has offered a novel, model-based challenge to those who argue that the internal workings of science can and should be kept free from the influence of social values. He contends that model-based assignments of probability to hypotheses about future climate change are unavoidably influenced by social values. I raise two objections to Winsberg’s argument, neither of which can wholly undermine its conclusion but (...) each of which suggests that his argument exaggerates the influence of social values on estimates of uncertainty in climate prediction. I then show how a more traditional challenge to the value-free ideal seems tailor-made for the climate context. (shrink)

Ian Parker has been a leading light in the fields of critical and discursive psychology for over 25 years. The Psychology After Critique series brings together for the first time his most important papers. Each volume in the series has been prepared by Ian Parker and presents a newly written introduction and focused overview of a key topic area. Psychology After the Unconscious is the fifth volume in the series and addresses three central questions: - Why is Freud's (...) concept of the unconscious important today? - Does language itself play a role in the creation of the unconscious? - How does Lacan radicalize Freud's notion of the unconscious in relation to cultural research? The book provides a clear explanation of Freudian and Lacanian accounts of the unconscious. It also highlights their role in offering a new way of describing, understanding and working with the human subject in clinical settings and in cultural research. Part One shows how the unconscious is elaborated in Freud's early case studies in Studies on Hysteria, while Part Two focuses on Lacan's re-working of the unconscious and its relationship to language and culture in his influential public seminars. The book also provides access to key debates currently occurring in Freudian and Lacanian psychoanalysis, exploring both the clinical dimension and the consequences for psychological and cultural research. Psychology After the Unconscious is essential reading for students and researchers in psychology, psychosocial studies, sociology, social anthropology and cultural studies, and to psychoanalysts of different traditions engaged in academic research. It will also introduce key ideas and debates within critical psychology to undergraduates and postgraduate students across the social sciences. (shrink)

This paper focuses on the most common state policy responses to the opioid crisis, dividing them into six broad categories. Within each category we highlight the rationale behind the group of policies within it, discuss the details and support for individual policies, and explore the research base behind them. The objective is to better understand the most prevalent state responses to the opioid crisis.

Allan Franklin has identified a number of strategies that scientists use to build confidence in experimental results. This paper shows that Franklin's strategies have direct analogues in the context of computer simulation and then suggests that one of his strategies—the so-called 'Sherlock Holmes' strategy—deserves a privileged place within the epistemologies of experiment and simulation. In particular, it is argued that while the successful application of even several of Franklin's other strategies (or their analogues in simulation) may not be sufficient for (...) justified belief in results, the successful application of a slightly elaborated version of the Sherlock Holmes strategy is sufficient. (shrink)

ABSTRACT Refugees crossing the Mediterranean Sea in small boats has become a common sight in the media, particularly since the so-called ‘refugee crisis’ in 2015. The number of boats crossing the English Channel between the French and UK coasts has been increasing as other migration routes have been closed down. This article reports the findings of a discourse analysis of 96 UK newspaper articles published in December 2018 when the daily crossings were referred to as a ‘major crisis’. Adopting a (...) broadly critical discursive psychology perspective, we identify the use of three main interpretative repertoires used within the media reporting. Firstly, a ‘secure the borders’ repertoire which positions the UK’s borders as porous and easily breached, secondly, a ‘smuggling is immoral’ repertoire which works to position smugglers as to blame for the current ‘crisis’ and removes responsibility for the crisis from the Government, and finally, a ‘desperate people’ repertoire which worked to position the refugees themselves as vulnerable and in need of protection, but also as people who will engage in risky behaviours. We suggest that the use of these repertoires ultimately functions to obscure the need for safe and legal migration routes to the UK. (shrink)

In 1904, Norwegian physicist Vilhelm Bjerknes published what would become a landmark paper in the history of meteorology. In that paper, he proposed that daily weather forecasts could be made by calculating later states of the atmosphere from an earlier state using the laws of hydrodynamics and thermodynamics (Bjerknes 1904). He outlined a set of differential equations to be solved and advocated the development of graphical and numerical solution methods, since analytic solution was out of the question. Using these theory-based (...) equations to produce daily forecasts, however, turned out to be more difficult than anticipated. Graphical solution techniques had limited success, and a first attempt to use .. (shrink)

Clear and careful thinking is an indispensable aid in the pursuit of answers to the difficult ethical question faced by clinicians, patients, and families. In this issue of The Journal of Medicine and Philosophy devoted to issues in clinical ethics, the authors engage in this enterprise by reflecting on morally good medical decision making, conscientious objection, presumed consent in organ donation, the permissibility of surrogate decision making, and the failure of legislative limits on the scope of euthanasia in Belgium.