Many servicemen and women began suffering from a variety of symptoms and illnesses soon after the 1991 Gulf War. Some veterans believe that their illnesses are related to toxic exposures during their service, though scientific research has been largely unable to demonstrate any link. Disputes over the definition, etiology, and treatment of Gulf War-related illnesses continue. The authors examine the roles of science, policy, and veteran activism in developing an understanding of GWRIs. They argue that the government’s stress-based explanation of (...) GWRIs and its insistence on a scientific link between service in the gulf and veteran illnesses forced veterans to shift from pleas for care, treatment, and compensation on moral grounds to engagement in the scientific process and debates over the interpretation of scientific findings. The authors compare the experiences of veterans to those of breast cancer activists to explain the stages of illness contestation in general. (shrink)

There are challenges to the dominant research paradigm in breast cancer science. In the United States, science and social activism create paradigmatic shifts. Using interviews, ethnographic observations, and an extensive review of the literature, we create a three-dimensional model to situate changes in scientific controversy concerning environmental causes of breast cancer. We identify three paradigm challenges posed by activists and some scientists: to move debates about causation upstream to address causes; to shift emphasis from individual to modifiable societal-level factors beyond (...) an individual’s control; and to allow direct lay involvement in research, which may raise new questions and change how questions are approached, the methods used, and the standards of proof. We use our model to examine controversies about doing scientific research, interpreting scientific results, and acting on science. Ultimately, we aim to understand what impedes construction of new methodologies and knowledge about environmental factors in human disease. (shrink)

This article presents seven principles that have guided our thinking about emotional intelligence, some of them new. We have reformulated our original ability model here guided by these principles, clarified earlier statements of the model that were unclear, and revised portions of it in response to current research. In this revision, we also positioned emotional intelligence amidst other hot intelligences including personal and social intelligences, and examined the implications of the changes to the model. We discuss the present and future (...) of the concept of emotional intelligence as a mental ability. (shrink)

Chipman, Meagher and Barwise (2024) propose a framework to interrogate public health responsibilities for populations with limited proficiency in the predominant language. We agree with many of the...

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion (...) demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels. (shrink)

The field of computational law has increasingly moved into the focus of the scientific community, with recent research analysing its issues and risks. In this article, we seek to draw a structured and comprehensive list of societal issues that the deployment of automatically processable regulation could entail. We do this by systematically exploring attributes of the law that are being challenged through its encoding and by taking stock of what issues current projects in this field raise. This article adds to (...) the current literature not only by providing a needed framework to structure arising issues of computational law but also by bridging the gap between theoretical literature and practical implementation. Key findings of this article are: (1) The primary benefit (efficiency vs. accessibility) sought after when encoding law matters with respect to the issues such an endeavor triggers; (2) Specific characteristics of a project—project type, degree of mediation by computers, and potential for divergence of interests—each impact the overall number of societal issues arising from the implementation of automatically processable regulation. (shrink)

Research on justice climate demonstrates a consistent effect on workgroup outcomes such as job satisfaction, commitment, and performance. However, little research considers how justice climate affects these outcomes and when the relationship is stronger or weaker. In an effort to extend the literature on justice climate, we draw on research on other types of organizational climate to suggest justice climate influences the fair behavior of coworkers. Specifically, we propose fair coworker behavior mediates the relationship between justice climate and outcomes. Further, (...) we examine the influence of workgroup structure on this mediated relationship. We examine these relationships in two studies and find support for the mediating effect of fair coworker behavior and the proposed moderated mediation model. Implications of these results for justice and climate research are considered. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

An important challenge when creating automatically processable laws concerns open-textured terms. The ability to measure open-texture can assist in determining the feasibility of encoding regulation and where additional legal information is required to properly assess a legal issue or dispute. In this article, we propose a novel conceptualisation of open-texture with the aim of determining the extent of open-textured terms in legal documents. We conceptualise open-texture as a lever whose state is impacted by three types of forces: internal forces (the (...) words within the text themselves), external forces (the resources brought to challenge the definition of words), and lateral forces (the merit of such challenges). We tested part of this conceptualisation with 26 participants by investigating agreement in paired annotators. Five key findings emerged. First, agreement on which words are open-texture within a legal text is possible and statistically significant. Second, agreement is even high at an average inter-rater reliability of 0.7 (Cohen’s kappa). Third, when there is agreement on the words, agreement on the Open-Texture Value is high. Fourth, there is a dependence between the Open-Texture Value and reasons invoked behind open-texture. Fifth, involving only four annotators can yield similar results compared to involving twenty more when it comes to only flagging clauses containing open-texture. We conclude the article by discussing limitations of our experiment and which remaining questions in real life cases are still outstanding. (shrink)

Department of Medical Education, Flinders University of South Australia, GPO Box 2100, Adelaide SA 5001. Tel. : +61-8-7225-1111; Fax: +61-8-8204-5675; Email: lee0359{at}flinders.edu.au ' + u + '@ ' + d + ' '/ /- ->.This paper analyses the role of communication strategies in pandemic influenza planning. Our central concern is with the extent to which nations are using communication to address issues of social justice. Issues associated with disadvantage and vulnerability to infection in the event of an influenza pandemic raise (...) distinct questions about how well less well off groups will be protected. The potential for a public health emergency of this type to exacerbate existing inequalities, making those in less well off positions worse off, makes social justice an important consideration for pandemic planners. National PI plans offer insights into the ways that nations may use communication to address issues of disadvantage, thereby providing a way of examining how communication strategies are presented and their potential to mitigate inequities. Our research reviewed 12 national PI plans and assessed the extent to which nations are using communication to assist and limit possible harms to less well off groups. We outline in this paper some important issues and considerations associated with social justice and flu planning, in particular if and how plans are addressing inequalities. CiteULike Connotea Del.icio.us What's this? (shrink)

Name der Zeitschrift: Frühmittelalterliche Studien Jahrgang: 36 Heft: 2 Seiten: 269-285.

Technology has expanded genomic research and the complexity of extracted gene-related information. Health-related genomic incidental findings pose new dilemmas for nurse researchers regarding the ethical application of disclosure to participants. Consequently, informed consent specific to incidental findings is recommended. Critical Social Theory is used as a guide in recognition of the changing meaning of informed consent and to serve as a framework to inform nursing of the ethical application of disclosure consent in genomic nursing research practices.

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that themselves worsen pain (...) by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

The development of person‐centred practice is inextricably linked with the debate about being a person and personhood. This debate takes on a particular relevance when certain prerequisites, which are often used as defining characteristics of persons, can no longer be autonomously fulfilled. This is the case, for example, with intensive care patients who are often (temporarily) impaired in their responsiveness and consciousness due to their critical state of health. Due to sedation, severity of illness and loss of voice, delivery of (...) person‐centred care in the intensive care setting is described as challenging. Despite far reaching implications on the therapeutic, ethical, and legal handling of patients in the intensive care setting, a definition of personhood at the stage of briefly diminished (by anesthetic measures), limited, or absent consciousness and ability to communicate has so far been discussed only superficially. To meet this challenge and to develop an understanding of person‐centred practice suitable for the context of intensive care, Emmanuel Levinas’ relational ethics and his understanding of radical alterity is discussed. We uncover the implications of Levinas Ethics of Radical Alterity on the care of the unconscious and unresponsive patient in the intensive care unit and further on the person‐centred approach to practice. The perspectives proposed in this paper provide an opportunity for the ontological embedding of a person‐centred care approach, which makes it possible to meet and care for these patients in a person‐centred manner. (shrink)

In cultures with left-right-script, agentic behavior is mentally represented as following a left-to-right trajectory, an effect referred to as the Spatial Agency Bias. In this research, we investigated whether spatial representations of activities are universal across activities by analyzing the opposite concepts of “attack” and “defense”. Both behaviors involve similar actions but may differ in perceived agency. Moreover “defense” is necessarily always a response to an attack and may therefore be represented by a trajectory in the opposite direction. Two studies (...) found the classic SAB for activities representing attacking but a reduction and reversal for activities involving defense. Although the spatial representation of defense on the right was much weaker and less unequivocal than that of attack on the left, the results suggest that the spatial representations of defense and attack are located in different positions. Apparently not all actors and all activities are spatially represented on the left with a left-to-right trajectory but position and direction depend on the perceived agency. Directions for future research and applications of our findings are discussed. (shrink)

Risk prediction in emergency medicine (EM) holds unique challenges due to issues surrounding urgency, blurry research-practise distinctions, and the high-pressure environment in emergency departments (ED). Artificial intelligence (AI) risk prediction tools have been developed with the aim of streamlining triaging processes and mitigating perennial issues affecting EDs globally, such as overcrowding and delays. The implementation of these tools is complicated by the potential risks associated with over-triage and under-triage, untraceable false positives, as well as the potential for the biases of (...) healthcare professionals toward technology leading to the incorrect usage of such tools. This paper explores risk surrounding these issues in an analysis of a case study involving a machine learning triage tool called the Score for Emergency Risk Prediction (SERP) in Singapore. This tool is used for estimating mortality risk in presentation at the ED. After two successful retrospective studies demonstrating SERP’s strong predictive accuracy, researchers decided that the pre-implementation randomised controlled trial (RCT) would not be feasible due to how the tool interacts with clinical judgement, complicating the blinded arm of the trial. This led them to consider other methods of testing SERP’s real-world capabilities, such as ongoing-evaluation type studies. We discuss the outcomes of a risk–benefit analysis to argue that the proposed implementation strategy is ethically appropriate and aligns with improvement-focused and systemic approaches to implementation, especially the learning health systems framework (LHS) to ensure safety, efficacy, and ongoing learning. (shrink)

Muhammad al-Shahrastani, the famous Muslim theologian of the 12th century and author of the Book of Religious and Philosophical Sects, was greatly influenced by Ismaili teachings. In this work al-Shahrastani refutes the metaphysics of Ibn Sina (Avicenna) from an Ismaili point of view.

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical (...) and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. (shrink)

ZusammenfassungDie Schaffung optimaler Rahmenbedingungen für eine möglichst individualisierte Athletenentwicklung stellt Leistungssportorganisationen vor vielschichtige Herausforderungen. Im vorliegenden Beitrag begründen wir das Design eines Organisationsentwicklungsprogramms zur Förderung der individualisierten Athletenentwicklung, welches derzeit im Netzwerk aus dem Olympiastützpunkt und Bundesstützpunkten der Metropolregion Rhein-Neckar implementiert, evaluiert und optimiert wird. Im Rahmen theoretischer Überlegungen wird zunächst gezeigt, dass Athletenentwicklung ein komplexer biopsychosozialer Prozess ist, der neben der Förderung sportmotorischer Höchstleistung auch die nachhaltige Gesunderhaltung und konstruktive Bewältigung alltäglicher Lebensaufgaben beinhaltet. Vor diesem Hintergrund konzipieren wir individualisierte (...) Athletenentwicklung als Managementaufgabe in Stützpunktnetzwerken des Leistungssports, die einen angemessenen Umgang mit Heterogenität, Interdisziplinarität und Flexibilität erfordert. Zudem wird die praktische Relevanz von partizipativen Ansätzen aus dem Bereich der Organisationsentwicklung verdeutlicht. Auf dieser Basis stellen wir die Konzeption der PRIO-Intervention vor, die im Kern aus drei vernetzten Phasen und einem prozessbegleitenden multi-stakeholder Koordinierungsteam besteht. Dieser Ansatz soll insbesondere den Athletinnen und Athleten die Möglichkeit geben, sich aktiv an der Entwicklung von Lösungen zur Optimierung ihres Stützpunktnetzwerks zu beteiligen. Durch die Evaluierung des Implementierungsprozesses lassen sich zudem neue Erkenntnisse über die Möglichkeiten und Grenzen partizipationsbasierter Interventionen der Organisationsentwicklung im Leistungssport gewinnen. (shrink)

This paper offers a new answer to an old question. Others have argued that exploitation is wrong because it is coercive, or degrading, or fails to protect the vulnerable. But these answers only work for certain cases; counterexamples are easily found. In this paper I identify a different answer to the question by placing exploitation within the larger family of wrongs to which it belongs. Exploitation is one species of wrongful gain, and exploiters always gain at the expense of others (...) by inflicting relative losses on disadvantaged parties. They do harm to their victims, even when their interactions are mutually advantageous, by failing to benefit the disadvantaged party as fairness requires. This failure is the essential wrong in every case of wrongful exploitation. At the end of the paper I assess how wrong this failure is as a way to gain at another's expense. (shrink)

Next SectionWhilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has (...) defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow. (shrink)

This book proposes a bold idea. Living beings are distinguishing distinctions. Single cells and multicellular organisms maintain themselves distinct by drawing distinctions. This is what organisms are and what they do. From this starting point, key issues examined range across ontology, epistemology, phenomenology, logic, and ethics. Topics discussed include the origin of life, the nature and purpose of biology, the relation between life and logic, the nature and limits of formal logic, the nature of subjects, the subject-object relation, subject-subject relationships (...) and the deep roots of ethics. The book provides a radical new foundation to think about philosophy and biology and appeals to researchers and students in these fields. It powerfully debunks mechanical thinking about living beings and shows the vast reservoir of insights into aliveness available in the arts and humanities. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

When developing computational models to analyze the tradeoffs between climate risk management strategies (i.e., mitigation, adaptation, or geoengineering), scientists make explicit and implicit decisions that are influenced by their beliefs, values and preferences. Model descriptions typically include only the explicit decisions and are silent on value judgments that may explain these decisions. Eliciting scientists’ mental models, a systematic approach to determining how they think about climate risk management, can help to gain a clearer understanding of their modeling decisions. In order (...) to identify and represent the role of values, beliefs and preferences on decisions, we used an augmented mental models research approach, namely values-informed mental models (ViMM). We conducted and qualitatively analyzed interviews with eleven climate risk management scientists. Our results suggest that these scientists use a similar decision framework to each other to think about modeling climate risk management tradeoffs, including eight specific decisions ranging from defining the model objectives to evaluating the model’s results. The influence of values on these decisions varied between our scientists and between the specific decisions. For instance, scientists invoked ethical values (e.g., concerns about human welfare) when defining objectives, but epistemic values (e.g., concerns about model consistency) were more influential when evaluating model results. ViMM can (i) enable insights that can inform the design of new computational models and (ii) make value judgments explicit and more inclusive of relevant values. This transparency can help model users to better discern the relevance of model results to their own decision framing and concerns. (shrink)