Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide (...) advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: impacts on healthcare costs, the outsourcing of expertise and issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries. (shrink)

Social impact investing is transforming the availability of private capital for nonprofits and social enterprises, but demand is not yet meeting supply. This paper analyzes the perceived barriers faced by nonprofits in engaging with SII, arguing the need to assess differences using a policy field framework. Four parameters of a subsector are conceptualized as shaping participation in SII: the scale of investment required, embeddedness in place, the need for radical innovation, and the configuration of intermediaries. Based on 25 interviews with (...) leaders of nonprofits and intermediaries in affordable housing and community economic development in Canada, the study finds that significant barriers are a lack of knowledge of the market, inadequate financial literacy, and the challenges of measuring and valuing social impacts. In addition, nonprofits report that, in spite of the inherent importance of social impact in this form of investing, they currently make limited use of evaluation and impact metrics, and perceive that intermediaries and investors, particularly in affordable housing, still put a greater emphasis on financial over social returns. (shrink)

The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given (...) the relatively low evidence standards currently required for regulatory approval of devices, this further indefinite reduction in standards raises serious ethical issues. Second, the pandemic has disrupted the usual operations of device representatives in hospitals, providing an opportunity to examine and refine this potentially ethically problematic practice. In this paper we explain and critically analyse the ethical implications of these two pandemic-related impacts on medical devices and propose suggestions for their management. These include an endpoint for pandemic-related adjustments to device regulation or a mechanism for continued refinement over time, together with a review of device research conducted under crisis conditions, support for the removal and replacement of emergency approved devices, and a review of device representative credentialling. (shrink)

Pursuing Justice in Africa focuses on the many actors pursuing many visions of justice across the African continent--their aspirations, divergent practices, and articulations of international and vernacular idioms of justice. The essays selected by editors Jessica Johnson and George H. Karekwaivanane engage with topics at the cutting edge of contemporary scholarship across a wide range of disciplines. These include activism, land tenure, international legal institutions, and post-conflict reconciliation. Building on recent work in sociolegal studies that foregrounds justice over and (...) above concepts such as human rights and legal pluralism, the contributors grapple with alternative approaches to the concept of justice and its relationships with law, morality, and rights. While the chapters are grounded in local experiences, they also attend to the ways in which national and international actors and processes influence, for better or worse, local experiences and understandings of justice. The result is a timely and original addition to scholarship on a topic of major scholarly and pragmatic interest. Contributors: Felicitas Becker, Jonathon L. Earle, Patrick Hoenig, Stacey Hynd, Fred Nyongesa Ikanda, Ngeyi Ruth Kanyongolo, Anna Macdonald, Bernadette Malunga, Alan Msosa, Benson A. Mulemi, Holly Porter, Duncan Scott, Olaf Zenker. (shrink)

Loss aversion can occur in riskless and risky choices. We present novel evidence on both in a non-student sample (660 randomly selected customers of a car manufacturer). We measure loss aversion in riskless choice in endowment effect experiments within and between subjects and find similar levels of average loss aversion in both. The subjects of the within study also participate in a simple lottery choice task which arguably measures loss aversion in risky choices. We find substantial heterogeneity in both measures (...) of loss aversion. Loss aversion in riskless choice and loss aversion in risky choice are strongly positively correlated, but on average riskless loss aversion is higher than risky loss aversion. We find that in both choice tasks, loss aversion increases in age, income, and wealth, and decreases in education. Our results provide novel supportive input to the debate about the reality of loss aversion. (shrink)

Data from 949 families of Caucasian and 400 families of Japanese ancestry who took part in the Hawaii Family Study of Cognition were used to ascertain the associations of parental cognitive ability, parental education and paternal occupation with offspring cognitive ability. In particular, analyses were focused on testing the possible moderating effects of parental socioeconomic status on the familial transmission of cognitive abilities. Parental cognitive ability was substantially associated and parental education and paternal occupation only trivially associated with offspring performance. (...) In contrast to the findings of Turkheimer etal. (2003), there was no evidence in these data that familiality for cognitive abilities was lower in the lower as opposed to upper levels of socioeconomic status. These results were consistent across measures, ethnicity and sex of offspring. (shrink)

The relationship between mental models and ethical decision making, along with the mechanisms through which mental models affect EDM, are not well understood. Using the sensemaking approach to EDM, we empirically tested the relationship of mental models to EDM. Participants were asked to depict their mental models in response to an ethics case to reveal their understanding of the ethical dilemma, and then provide a response, along with a rationale, to a different ethical problem. Findings indicated that complexity of respondents’ (...) mental models was related to EDM, and that this relationship was mediated by sensemaking processes. The implications of these findings for improving integrity training in organizations, as well as ultimately understanding the role of mental models in EDM, are discussed. (shrink)

The phenomenon whereby severely disabled persons self-report a higher than expected level of subjective well-being is called the “disability paradox.” One explanation for the paradox among brain injury survivors is “response shift,” an adjustment of one’s values, expectations, and perspective in the aftermath of a life-altering, disabling injury. The high level of subjective well-being appears paradoxical when viewed from the perspective of the non-disabled, who presume that those with severe disabilities experience a quality of life so poor that it might (...) make their lives not worth living. This presumption has profound consequences, for it may inform end-of-life choices made in advance directives, or influence decisions made by surrogates on behalf of persons who are unable to direct their own medical treatment. -/- Peterson et al propose a cautious, well-considered plan to use fMRI-based brain-computer interfaces to assess the decision making capacity of covertly aware, behaviorally non-responsive individuals who retain high levels of preserved cognition. Their plan, if it succeeds, could eventually restore autonomy and empower some severely disabled persons, allowing them to participate in clinical decision making. Peterson et al discuss possible in-principle objections to their proposal, among them the “argument from psychological health,” and the “changing sets of values” objection. These objections both presume that deviations from a pre-injury norm could indicate diminished decision making capacity. This presumption threatens the autonomy of the patient who is capable of making decisions, but whose post-injury decisions appear to diverge from pre-injury preferences or values. In light of the potential for response shift, and the disability paradox, it should not be inferred that changes in values or preferences are unreflective of the true current preferences of a brain-injured person, nor are they conclusive evidence of diminished capacity. Presuming diminished capacity on the basis of unexpected or unconventional preferences has, in the past, been used to disempower patients whose autonomy and capacity would not have been doubted had they made choices that accorded with the expectations or values of others. We must be cautious, and vigilant, to prevent similarly diminishing the autonomy of covertly aware, behaviorally non-responsive individuals on the basis of empirically and ethically questionable inferences about their decision making capacity. (shrink)

The 2010 Quinnipiac cheerleading case raises interesting questions about the nature of both cheerleading and sport, as well as about the moral character of each. In this paper we explore some of those questions, and argue that no form of college cheerleading currently in existence deserves, from a moral point of view, to be recognized as a sport for Title IX purposes. To reach that conclusion, we evaluate cheerleading using a quasi-legal argument based on the NCAA’s definition of sport and (...) conclude that cheerleading fails to qualify as a legitimate sport. A philosophical argument leads to the same conclusion, primarily because of the essential entertainment-aspect of cheerleading. We then examine a consequentialist moral case for making cheerleading an intercollegiate sport and argue that the balance of moral reasons is against doing so. Finally, we look at cheerleading’s newest offspring – Acrobatics and Tumbling, and STUNT – and express our moral reservations about their current claims to be worthy of Title IX recognition. While we would not claim that any single one of our arguments is decisive, we are convinced that the cumulative weight of the arguments against granting intercollegiate sport status to any of the forms of cheerleading or its derivatives is, at present, irresistible. (shrink)

This paper looks at an approach to Principle C in which the disjoint reference effect triggered by definite description arises because there is a preference for using bound pronouns in those cases. Philippe Schlenker has linked this approach to the idea that the NP part of a definite description should be the most minimal in content relative to a certain communicative goal. On a popular view about what the syntax and semantics of a personal pronoun is, that should have the (...) effect of favoring a pronoun over a definite description. This paper shows how that can be made the source of “Vehicle Change,” an effect in ellipsis contexts in which definite descriptions seem to behave like pronouns. It requires, however, a way of distinguishing bound pronouns from non-bound pronouns, and the paper makes a proposal about how these two kinds of pronouns can be distinguished in the way needed. (shrink)

This research was designed to understand better the patterns of agricultural intensification and transformation occurring in Africa south of the Sahara using the Ghanaian case. The paper examines changes in farming systems and the role of various endogenous and exogenous factors in driving the conversion of arable lands to agricultural uses in four villages within two agro-ecologically distinct zones of Ghana: the Guinea Savannah and Transition zones. Using historical narratives and land-cover maps supplemented with quantitative data at regional levels, the (...) research shows that farming has intensified in the villages, as farmers increased their farm size in response to factors such as population growth, market access, and changing rural lifestyle. The overall trend suggests a gradual move toward intensification through increasing use of labor-saving technologies rather than land-saving inputs—a pattern that contrasts with Asia’s path to its Green Revolution. The findings in this paper provide evidence of the dynamism occurring in African farming systems; hence, they point toward a departure from stagnation narratives that have come to prevail in the debate on agricultural transformation and intensification in Africa south of the Sahara. We conclude that it is essential for future research to expand the scope of this work, while policies should focus on lessons learned from these historical processes of genuine change and adaptation. (shrink)

: National bioethics commissions have been critiqued for a variety of structural, procedural, and political aspects of their work. A more recent critique published by Dzur and Levin uses political philosophy to constructively critique the work of national bioethics commissions as public deliberative forums. However, this public forum critique of bioethics commissions ignores empirical research in political science and normative claims that suggest that advisory commissions can and should have diverse of functions beyond that of being public forums. The present (...) paper argues that the public forum critique too narrowly considers the roles that bioethics commissions can play in public bioethics and ignores the moral obligation of commissions to fulfill their mandates. Evaluations of commissions must consider that these institutions can serve in capacities other than those of a public deliberative forum and use additional measures to evaluate the multiple roles and successes of bioethics commissions in public policy. (shrink)

Is the market civilizing or destructive? The increased salience of science commercialization is forcing scientists to address this question. Benefiting from the sociology of morality literature’s increased attention to specific kinds of morality and engaging with economic sociology’s moral markets literature, we generate competing hypotheses about scientists’ value-driven attitudes toward patenting. The Civilizing Market thesis suggests scientists who prioritize universalism will tend to support patenting. The Destructive Market thesis, by contrast, suggests universalism will be correlated with opposition to patenting. We (...) analyze survey data from biologists and physicists nested within academic organizations, which are nested within the following regions: France, Hong Kong, India, Italy, Taiwan, Turkey, UK, and the USA. Employing multilevel analysis, we find correlational evidence to support the Destructive Market thesis. Universalism is associated with anti-patenting attitudes, suggesting scientists expect patenting to have deleterious effects on science and society. We end with a discussion of this article’s implications for the moral markets literature, sociology of morality and business ethics. (shrink)

Did Aristotle consider the properties of the elements to be teleologically explicable? According to some commentators, he did not, but considered these to operate according to material, moving, or mechanical causes. According to others, he did, and this is evidence of his commitment to an “overall” or “global” teleology. Both of the positions are wrong. Aristotle did consider each of the elements teleologically explicable, but he considered the beneficiaries of their properties and motions to be the elements themselves. This is (...) relatively clear in the case of ether, the element that composes the heavenly bodies: it has a simple motion in a circle, which is a manifestation of the intelligence of the extra-terrestrial bodies. But the other elements are included in a cycle of transmutation that guarantees their perpetual existence. This is a benefit to them according to the axiom: it is better to exist than not exist. Thus, rainfall is a necessary and cyclical process, but it is also somehow benefits the elements that are transformed in the process, for in so doing they complete cycles that resemble or imitate the eternal cycles of the heavenly bodies. (shrink)

This article examines the intrinsic and instrumental value of higher education, in relation to jobs that do not exist anymore and jobs that do not exist yet.

This article's thesis is that religion and science are ultimately about the same thing, that they affect one another, and that people in the two fields therefore need to communicate. The authors begin by discussing the importance of ethical transformations to a life of love and character, arguing that the development of a technological society does not free us from ethical demands. They then move to advocating dialogue about the shared truths of science and religion. Wanting both, and positing that (...) the former is a foundation for the latter, the authors state that Einstein's famous logian cannot be ignored: "The situation may be expressed by an image: Science without religion is lame, religion without science is blind". (shrink)

La ciencia a lo largo de su historia ha estado fundamentada por múltiples enfoques filosóficos, sin embargo, han existido dos tradiciones hegemónicas que componen el dualismo de la investigación cualitativa y cuantitativa. En este artículo, además de criticar dicho dualismo, se propone una ontología alternativa de investigación cualitativa que supere el reduccionismo subjetivista. Para ello, se considera la concepción de la realidad de Max Scheler. En dicha nueva ontología, la ciencia cualitativa estudiaría un mundo compuesto por aspectos objetivos y subjetivos. (...) En este sentido, su objeto de estudio se ampliaría a diferentes posibilidades, por ejemplo, la intención de explicar, predecir, controlar, explorar y comprender los fenómenos de la realidad. (shrink)