Children like Baby G, born with complex chronic medical conditions that compromise function in the long term, are an increasing presence in tertiary-level neonatal intensive care units. The parents and health-care providers of these children are faced with profoundly difficult decisions. Whether severe congenital anomalies with poor prognosis are diagnosed antenatally or are discovered at the time of birth, the issues are vexing, and the impact decisions will have on everyone in the family is profound. What should such decisions be (...) based upon? What values and principles might guide the decision-making process? What moral justifications allow for pursuing.. (shrink)

The explicit objective for the 2014 Symposium hosted by the University of North Florida, which serves as the basis for this collection of papers, was to explore the relationship and potential for mutual support between the disciplines of child rights and pediatric bioethics in advancing the health and well-being of children in the United States and around the world. The U.N. Convention on the Rights of the Child served as the locus for this discussion. A significant question emerged in the (...) Symposium about whether the CRC could serve any beneficial purpose in the United States, where it has not yet been ratified. Further, there was.. (shrink)

In this article, we examine how the U.N. Convention on the Rights of the Child can be useful in pediatric bioethics. Adopted in 1989, the CRC reflects norms that have been deliberated upon for a long period of time and endorsed by most nations. The United States is now the only country that has not ratified the CRC.1 International human rights law shares many key moral concepts with clinical pediatric bioethics, and the CRC provides a considered language common to many (...) jurisdictions that can assist bioethicists in their daily practice and help health-care organizations in their policy development and international interactions. There may, however, be practical challenges with using the CRC in the practice of.. (shrink)

Born at 24 weeks gestation, Baby G now lies in a neonatal intensive care unit two months post-birth. He has pulmonary hypoplasia, congenital scoliosis, and swallowing issues that will require placement of a feeding tube, and bowel dystonia that interferes with his ability to absorb feedings. Shortly after birth, he experienced a cardiopulmonary arrest and now has obvious neurological impairments. As a result of incomplete development of his lungs and severe chronic lung disease, he cannot breathe on his own. Because (...) of his chronic respiratory failure, tracheostomy and long-term assisted ventilation was offered as an option that would allow him to be discharged from the acute care setting. However, his congenital.. (shrink)

The manuscripts in this issue of Perspectives in Biology and Medicine reflect the work of an international group of pediatric bioethicists and child rights advocates who convened in March 2014 to pursue several questions related to the intersection of pediatric bioethics and child rights. The prequel for the Symposium involved several years of dialogue between the editors of this volume—dialogue through which it became clear that there was much to be learned about our respective disciplines and how they might inform (...) our heretofore mutually exclusive work.The principles of pediatric bioethics have been used for decades to analyze and help resolve challenging clinical situations in pediatrics, but there has been.. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a (...) positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. (shrink)

Can the institutional systems that prepare Black nurse researchers question the ways their systemic pathways have impacted health equity knowledge development in nursing? We invite our readers to keep this question in mind and engage with our conversation as Black nurse researchers, scholars, educators, and clinicians. The purpose of our conversation, and this article, is to explore the transactional impact of knowledge development pathways and Black faculty retention pathways on the state of health equity knowledge in nursing today. Over a (...) series of conversations, we discuss the research exploitation of communities of color, deficit research funding, knowledge capitalization, the marginalization of diversity as a continuous process, a lack of sociocultural authority, and our thoughts on solutions. We conclude by using the wisdom of a generation to answer our initial question. (shrink)

This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the (...) problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. (shrink)

This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

This project examined the ethical issues faced by academics and professionals in the Humanities. We conducted focus groups to gather information about the ethical concerns in these fields and used the qualitative data arising from the discussions to create a taxonomy that represents the structure of ethical issues in the Humanities. A key implication of our findings is that while the focus of ethics research and interventions has been primarily on the sciences and engineering, academics and professionals in other fields (...) also encounter some unique critical ethical dilemmas that require further research and methods of intervention. (shrink)

Digital personal data is increasingly framed as the basis of contemporary economies, representing an important new asset class. Control over these data assets seems to explain the emergence and dominance of so-called “Big Tech” firms, consisting of Apple, Microsoft, Amazon, Google/alphabet, and Facebook. These US-based firms are some of the largest in the world by market capitalization, a position that they retain despite growing policy and public condemnation—or “techlash”—of their market power based on their monopolistic control of personal data. We (...) analyse the transformation of personal data into an asset in order to explore how personal data is accounted for, governed, and valued by Big Tech firms and other political-economic actors. However, our findings show that Big Tech firms turn “users” and “user engagement” into assets through the performative measurement, governance, and valuation of user metrics, rather than extending ownership and control rights over personal data per se. We conceptualize this strategy as a form of “techcraft” to center attention on the means and mechanisms that Big Tech firms deploy to make users and user data measurable and legible as future revenue streams. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

In an incendiary 2010 Nature article, M. A. Nowak, C. E. Tarnita, and E. O. Wilson present a savage critique of the best-known and most widely used framework for the study of social evolution, W. D. Hamilton’s theory of kin selection. More than a hundred biologists have since rallied to the theory’s defence, but Nowak et al. maintain that their arguments ‘stand unrefuted’. Here I consider the most contentious claim Nowak et al. defend: that Hamilton’s rule, the core explanatory principle (...) of kin selection theory, ‘almost never holds’. I first distinguish two versions of Hamilton’s rule in contemporary theory: a special version (HRS) that requires restrictive assumptions, and a general version (HRG) that does not. I then show that Nowak et al. are most charitably construed as arguing that HRS almost never holds, while HRG buys its generality at the expense of explanatory power. While their arguments against HRS are fairly uncontroversial, their arguments against HRG are more contentious, yet these have been largely overlooked in the ensuing furore. I consider the arguments for and against the explanatory value of HRG, with a view to assessing what exactly is at stake in the debate. I suggest that the debate hinges on issues concerning the causal interpretability of regression coefficients, and concerning the explanatory function Hamilton’s rule is intended to serve. (shrink)

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case (...) was viewed as positive or negative, and whether the outcomes, processes, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision making are discussed. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Abstract:AbstractOne of the most recognized playwrights and stage directors on the African continent today, Werewere Liking is the Cameroonian founder of the Village et Fondation Panafricaine Ki-yi Mbock in Abidjan. A 2000 Prince Claus Award laureate for her contributions to culture and development, Liking has also produced impressive works of literature and art. From the beginning of her career in the late 1970s, Liking has always promoted and expanded her project of elite theater for development, with her productions of the (...) last decade bringing to the masses theater and performance as a form of resistance to the surrounding conflict and chaos in the West African nations of Cote-d'Ivoire and, most recently, Mali. The ability of Liking and the Village to carry out their projects to fruition both in times of relative prosperity as well as in periods of conflict is a testament to Liking's successful matriarchal style of African feminist leadership and shared governance made possible by the espousing of traditional African values necessary for tackling problems of a contemporary world. (shrink)

From mitochondria to meerkats, the natural world is full of spectacular examples of social behaviour. In the early 1960s W. D. Hamilton changed the way we think about how such behaviour evolves. He introduced three key innovations - now known as Hamilton's rule, kin selection, and inclusive fitness - and his pioneering work kick-started a research program now known as social evolution theory. This is a book about the philosophical foundations and future prospects of that program. [Note: only the Introduction (...) is available to download.]. (shrink)

The Knowledge-Based Bio-Economy has gained prominence as an agricultural R&D agenda of the European Union. Specific research policies are justified as necessary to create a KBBE for societal progress. Playing the role of a master narrative, the KBBE attracts rival visions; each favours a different diagnosis of unsustainable agriculture and its remedies in agro-food innovation. Each vision links a technoscientific paradigm with a quality paradigm: the dominant life sciences vision combines converging technologies with decomposability, while a marginal one combines agro-ecology (...) with integral product integrity. From these divergent visions, rival stakeholder networks contend for influence over research policies and priorities, especially within the Framework Programme 7 on Food, Agriculture, Fisheries and Biotechnology, which has aimed to promote a Knowledge-Based Bio-Economy. Although the FAFB programme has favoured a life sciences vision, agro-ecological approaches have gained a presence, thus overcoming their general lock-out from agricultural research agendas. In their own way, each rival paradigm emphasises the need for collective systems to gather information for linking producers with users, as a rationale for the public sector to fund distinctive research priorities. (shrink)

In a recently published article I have suggested an amendment of the textual crux in Suetonius, Tiberius 21. 4 and an interpretation of the passage as providing direct evidence that the arrangement of the marriages of Germanicus and the younger Drusus was integral to Augustus' settlement of 26 June a.d. 4, even if they were not celebrated until early 5. This view differs from the more usual assumption that while the marriages took place in 5, the date of their arrangement (...) was not particularly significant, or from the possibility implied by Levick that Germanicus' marriage may have been arranged to placate the ‘faction’ of the elder Julia after the consolidation in 4 of the position of Livia's descendants. The more precise hypothesis that the marriages were intended as part of the settlement may help us to bring into sharper focus some of the political events of the next few years, and this article attempts to do so; in particular it looks at the internal balance of the settlement; the anomalous separate adoption of Agrippa Postumus; and the decline and fall of Agrippa Postumus and the younger Julia. First, however, some further observations on the hypothesis in my earlier article. (shrink)

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision making. Using a sample of 163 undergraduates, a low-fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision making. A mediated model is presented which suggests that environmental factors influence reasoning (...) strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision making. Findings were mixed but generally supported the hypothesized model. It is interesting to note that framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. (shrink)

This PhD dissertation examines the conceptual and theoretical foundations of the most general and most widely used framework for understanding social evolution, W. D. Hamilton's theory of kin selection. While the core idea is intuitive enough (when organisms share genes, they sometimes have an evolutionary incentive to help one another), its apparent simplicity masks a host of conceptual subtleties, and the theory has proved a perennial source of controversy in evolutionary biology. To move towards a resolution of these controversies, we (...) need a careful and rigorous analysis of the philosophical foundations of the theory. My aim in this work is to provide such an analysis. I begin with an examination of the concepts behavioural ecologists employ to describe and classify types of social behaviour. I stress the need to distinguish concepts that are often conflated: for example, we need to distinguish simple cooperation from collaboration in collective tasks, behaviours from strategies, and control from manipulation and coercion. I proceed from here to the formal representation of kin selection via George R. Price’s covariance selection mathematics. I address a number of interpretative issues the Price formalism raises, including the vexed question of whether kin selection theory is ‘formally equivalent’ to multi-level selection theory. In the second half of the dissertation, I assess the uses and limits of Hamilton’s rule for the evolution of social behaviour; I provide a precise statement of the conditions under which the rival neighbour-modulated fitness and inclusive fitness approaches in contemporary kin selection theory are equivalent (and describe cases in which they are not); and I criticize recent formal attempts to establish the controversial claim that kin selection leads to organisms behaving as if maximizing their inclusive fitness. (shrink)

Suetonius quotes at Tiberius 21. 4–7 a number of passages from letters of Augustus to Tiberius showing the high regard in which he professed to hold him, despite his reservations about the darker side of his character, once he had decided to adopt him ‘rei publicae causa’ in a.d 4. They seem to have attracted little critical comment, although Seager connects them with the handling by Tiberius of the Pannonian revolt in a.d. 6–9. suggesting that in view of their fulsome (...) character they were probably written towards the end of this period, when the crisis was past, rather than earlier when Augustus may have been critical of Tiberius’ caution in prosecuting the war. But he does not attempt a more detailed appraisal of the possible dates of the individual letters quoted. Sections 21. 4 and 5 in particular present interesting textual difficulties, mainly arising from the transmission of Greek in a predominantly Latin text: this article discusses these with a view to throwing greater light on the historical significance of the letters. First, the text, to which I have appended a limited apparatus which concentrates on the points of greatest difficulty. (shrink)

Kin selection and group selection were once seen as competing explanatory hypotheses but now tend to be seen as equivalent ways of describing the same basic idea. Yet this ‘equivalence thesis’ seems not to have brought proponents of kin selection and group selection any closer together. This may be because the equivalence thesis merely shows the equivalence of two statistical formalisms without saying anything about causality. W.D. Hamilton was the first to derive an equivalence result of this type. Yet Hamilton (...) was aware of its limitations, and saw that, while illuminating, it papered over some biologically important distinctions. Attending to these distinctions leads to the concept of ‘K-G space’, which helps us see where the biological disagreements between proponents of kin selection and group selection really lie. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

The Sanskrit D?rgh?gama manuscript is a Sarv?stiv?da/M?lasarv?stiv?da text containing a collection of ancient canonical Buddhist s?tras, composed in Sanskrit and written on birch bark folios. This collection had been lost for centuries and was rediscovered in the late twentieth century. In this paper, I examine key instances of intertextuality between a new edition of a s?tra from the Sarv?stiv?da D?rgh?gama – the Sanskrit Pras?dan?ya-s?tra –, the Pali Sampas?dan?ya-sutta, and Chinese???? – the three corresponding versions of this text in the?gama/nik?ya (...) collections of the Sarv?stiv?da, Therav?da, and Dharmaguptaka schools. Hence, contradictions among the texts that are not easily explainable will be shown, uncovering apparent confusion among the creators of these texts and hopefully shedding new light on our understanding of these texts. (shrink)

The Bible has influenced contemporary culture both positively and negatively. The present volume is a collection of papers that were discussed at an international colloquium on the use of the Bible in Ethics in the Department of Biblical Studies at the University of Sheffield in April 1995. Participants came from many parts of the world and from different backgrounds, and the papers reflect their varied interests and the contexts in which they work. The contributors, in addition to the three editors, (...) are John Barton, Bruce Birch, Mark Brett, Mark Chapman, David Clines, Philip Davies, Cheryl Exum, Stephen Fowl, Norman Gottwald, John Haldane, Walter Houston, Sharon Ringe, Chrisopher Rowland, Lisa Sowle Cahill and Gerald West. (shrink)