Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

Paul O'Grady clearly distinguishes five main kinds: relativism about truth, relativism about logic, ontological relativism, epistemological relativism, and, finally, relativism about rationality. In each case he shows what makes a position relativist and how it differs from a sceptical or pluralist position. He ends by presenting a thoroughly integrated position that rejects some forms while defending others. The book includes discussion of recent work by Putnam, Devitt, Searle, Priest, and Quine and offers a succinct survey of contemporary debates. This lively (...) discussion of the issue will be welcome reading for all those involved in philosophical inquiry. (shrink)

Some are concerned about the possibility that offering money for research participation can constitute coercion or undue influence capable of distorting the judgment of potential research subjects and compromising the voluntariness of their informed consent. The author recognizes that more often than not there are multiple influences leading to decisions, including decisions about research participation. The concept of undue influence is explored, as well as the question of whether or not there is something uniquely distorting about money as opposed to (...) a chance for treatment or medical care. An amount of money that is not excessive and is calculated on the basis of time or contribution may, rather than constitute an undue inducement, be an indication of respect for the time and contribution that research subjects make. (shrink)

Purpose/methods: This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions. Findings: The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master's degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, (...) versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses. Conclusion: Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers. (shrink)

Well before patient-centered or patient-controlled research became trendy, and earlier than calls to preferentially refer to research subjects as participants, Bob Veatch wrote “The Patient as Partner” Veatch presciently argued that research patients should not be thought of as passive subjects nor material from which to obtain data, but rather as partners in discovery. In this manuscript, I will explore Veatch’s conception of patient as partner in research and how that idea has evolved and been implemented over time and consider (...) some of the remaining challenges. Complexities of patient partnership include: clarifying the types of research in which patient partnership is most appropriate, recognizing the various possible levels of patient engagement in each case, avoiding tokenism and striving for respectful partnership, and keeping in mind the appropriate implementation of protections and safeguards. Bob Veatch would be pleased with the progress that has been made in creating research partnerships with patients, while also undoubtedly pushing us to continue to do better. (shrink)

Dr. Henry Beecher, a renowned Harvard Medical School anesthesiologist, sent shock waves through the medical research community and the lay press when he described 22 examples of “unethical or questionably ethical studies” by reputable researchers at major institutions in his now well-known 1966 New England Journal of Medicine article. Beecher concluded this exposé by noting: “The ethical approach to experimentation in man has several components: two are more important than the others, the first being informed consent.... Secondly, there is the (...) more reliable safeguard provided by the presence of an intelligent, informed, conscientious, compassionate, responsible investigator”. Beecher’s... (shrink)

In their target article, Morain and colleagues (2019) tackle the long-standing and thorny issue of whether and when it might be ethical for a physician-investigator to obtain research consent from...

There is a general consensus that Quine’s assault on analyticity and verificationism in ‘Two Dogma of Empiricism’ has been successful and that Carnap’s philosophical position has been vanquished. This paper so characterises Carnap’s position that it escapes Quine’s criticisms. It shows that the disagreement is not a first order dispute about analyticity or verificationism, but rather a deeper dispute about philosophical method.

Lynch and colleagues describe positive and cautionary lessons learned from recent extraordinary research efforts to develop COVID-19 vaccines and therapeutics and consider whether some of th...

Volume 19, Issue 9, September 2019, Page 5-7.

Wittgenstein is often associated with different forms of relativism. However, there is ambiguity and controversy about whether he defended relativistic views or not. This paper seeks to clarify this issue by disambiguating the notion of relativism and examining Wittgenstein's relevant texts in that light.

Nursing and bioethics have a lot in common because they share concerns about life and death, illness and health, the rights of individuals and communities, ethical patient care, health care delivery, and public health. Nurses and bioethicists contribute to ethical practice, ethics scholarship, and health policy‐making in a variety of ways. Some nurses have bioethics education or experience, some bioethicists study or collaborate closely with nurses, and some of us proudly identify as both bioethicists and as nurses. Despite certain shared (...) and interwoven aims, bioethicists and nurses often accomplish their goals in dissimilar ways, have diverse educational and training trajectories as well as distinct roles and responsibilities, and are viewed differently within health care organizations. Yet the work of bioethics and nursing can be, and in my view should more often be, synergistic. That synergism may be especially critical in the arena of health policy and ethics. Nurses can bring extraordinary insights and real‐world experiences to the policy table but are not always considered essential contributors. (shrink)

In this set of contributions to the Kennedy Institute of Ethics Journal celebrating the significant work and contributions of LeRoy Walters, we aim to bring new perspectives to topics that Dr. Walters helped to pioneer and continue his tradition of bringing moral insights and arguments to bear on the development of practical public and professional policies. Dr. Walters is well known for his invaluable service as member and chair of the Recombinant DNA Advisory Committee at the National Institutes of Health. (...) He also made major contributions to a variety of other committees responsible for the oversight of research and science, and to the development and implementation of influential... (shrink)

There is a general presumption that epistemology does not have anything to do with wellbeing. In this paper I challenge these assumption, by examining the aftermath of the Gettier examples, the debate between internalism and externalism and the rise of virtue epistemology. In focusing on the epistemic agent as the locus of normativity, virtue epistemology allows one to ask questions about epistemic goods and their relationship to other kinds of good, including the good of the agent. Specifically it is argued (...) that emotion has a positive role to play in epistemology, an example from Aquinas is used to illustrate this and to illustrate the different kinds of good involved in cognition. (shrink)

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

Vulnerability in research is often understood as a diminished ability to protect one's own interests, manifested by a compromised capacity to give informed or voluntary consent. Certain groups of people are thought to be more vulnerable than others and therefore are at risk of being exploited or mistreated in research. Accordingly, the federal regulations call for additional safeguards to protect vulnerable groups.There remains some ambiguity and contradiction, however, regarding what groups are vulnerable in research and why,3 since the available codes (...) of research ethics and regulations describe many groups as vulnerable. When so many groups are considered vulnerable, but no specification is offered as to how they are vulnerable or what particular protections are appropriate, the possibility of meaningful safeguards is diminished. In addition, current concepts of vulnerability are usually applied to whole groups of people, without distinguishing between individuals in a group who might truly have a compromised capacity to protect their own interests from those who do not. (shrink)

"...there is nothing elementary about O'Grady's primer. She pulls off the feat of writing a reliable and accessible introduction to modern philosophy that is also a meaningful contribution to the subject." - London Times Literary Supplement From Descartes' famous line 'I think therefore I am' to Kant's fascinating discussions of morality, the thinkers of the Enlightenment have helped to shape the modern world. Addressing such important subjects as the foundations of knowledge and the role of ethics, the theories of these (...) philosophers continue to have great relevance to our lives. Ranging across Enlightenment thinking from Berkeley to Rousseau, Enlightenment Philosophy in a Nutshell explains important ideas such as Locke's ideas of primary and secondary qualities, Kant's moral rationalism, and Hume's inductive reasoning. Filled with helpful diagrams and simple summaries of complex theories, this essential introduction brings the great ideas of the past to everyone. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Report on the Tenth European Network of Buddhist-Christian Studies Conference:History as a Challenge to Buddhism and ChristianityJohn O’Grady, Elizabeth J. Harris, and Jonathan A. SeitzThe Tenth Conference of the European Network of Buddhist-Christian Studies (ENBCS) brought together between sixty and seventy people at the Oude Abdij, Drongen, Belgium, between 27 June and 1 July 2013, to examine the theme “History as a Challenge to Buddhism and Christianity.” It was (...) a collaborative effort between the ENBCS and the Katholieke Universiteit Leuven. The 2011 ENBCS conference had focused on whether hope was a relevant concept for Buddhists and Christians. The choice of history as a theme complemented this. It also resonated with a research concern of both KU Leuven and the Network.Five key themes were chosen for examination: the traditional Christian and Buddhist conceptions of history; Jesus and the Buddha: fact and fiction; Buddhist and Christian historiography; dangerous memory in Christianity and Buddhism; and permitting historical consciousness in Buddhism and Christianity. Each was approached from a Buddhist and a Christian perspective. An opening lecture addressed the theme “Modern Historical Consciousness and the Challenge to Religion.” In addition, eighteen research papers on Buddhist-Christian relations were given in parallel sessions on Friday evening and Saturday morning. These covered topics as various as the writings of Edmund Pezet (Pierre Gillet), Paul Knitter’s understanding of Buddhist-Christian double belonging (Achim Riggert), Keiji Nishitani and the death of God (Jonatan Navarro Estrada), the encounter of Zen Buddhism and Christianity in the works of D. T. Suzuki (Mariusz Rucki), Buddhist-Christian encounters by Han Yong Woon (Seung Chul Kim), and “Liberating the Conflict from ‘History’ in Sri Lanka” (Jude Lal Fernando).Perry Schmidt-Leukel (Münster, Germany), in the opening lecture, discussed [End Page 189] seven challenges that modern historical consciousness was posing to religion: the challenge of falsification (when historical evidence, for example, showed some doctrines cherished by believers were not taught by the founder), the challenge of uncertainty or methodological doubt, the challenge of methodological naturalism (should a natural explanation be considered more probable than a supernatural one?), the challenge of the distance between past and present, the challenge of change (religions are not static), the challenge of demystification, and the challenge of relativity (the writing of history is perspectival, conditioned by context). He stressed that it would be a blessing to religion if these challenges were faced and, throughout the conference, encouraged other speakers to face them.The first theme was tackled by Mark Blum (Berkeley, USA) from a Buddhist perspective and Jan-Olav Henriksen (Norwegian School of Theology) from a Christian perspective. In a magisterial historical and geographical survey of the Buddhist tradition, Blum first noted that no one had unearthed a traditional notion of Buddhist history in the early texts. The theme of decline and reformation had been taken from Indian cosmology, but with a Buddhist twist and the conviction that it was pointless to talk about beginnings. And in the growth of the Mahāyāna tradition, a dehistoricization of the Buddha had occurred in the belief that the Buddha’s dharma-body was his only “real” body.Henriksen argued that Christian salvation history had its origin in the narrative of the Fall, an event for which there was no historical evidence, and developed into a history of God’s call (election) to all people that they should be brought together in community. It was a history that was linked with the divine logos, a force that Christian theology has seen as deeply interwoven into creation from the beginning of time and that was made human in Jesus.Terrence Merrigan (KU Leuven, Belgium), giving a Christian perspective on the second theme, distinguished three quests or attempts to reach the historical Jesus. The first, from 1774 to 1906, sought to uncover the Jesus that had been obscured by dogma. It imploded with the realization that separating “core” from “myth” was impossible, and conditioned a reactive “no-quest” in the first half of the twentieth century. A “new quest” arose in the 1950s, initiated by Käsemann’s reaction to the theologies of Barth and Bultmann. A further quest that appealed to archaeology and the... (shrink)

abstractBackground: Evidence shows both a tendency for research participants to conflate research and clinical care and a limited public understanding of research. Conflation of research and care by participants is often referred to as the therapeutic misconception. Despite this evidence, few studies have explicitly asked participants, and especially minors, to explain what they think research is and how they think it differs from regular medical care. Methods: As part of a longer semistructured interview evaluating assent and parental permission for research, (...) adolescent research participants (n = 177), including adolescents with illnesses and healthy volunteers, and their parents (n = 177) were asked to describe medical research in their own words and say whether and how they thought being in medical research was different from seeing a regular doctor. Qualitative responses were coded and themes were identified through an iterative process. Results: When asked to describe medical research, the majority described research in terms of its goals of helping to advance science, develop treatments and medicines, and help others; fewer described research as having the goal of helping particular research participants, and fewer still in terms of the methods used in research. The majority of teen and parent respondents said being in research is different than seeing a regular doctor and explained this by describing different goals, different or more procedures, differences in the engagement of the doctors/researchers, and differences in logistics. Conclusions: Adolescents participating in clinical research and their parents generally describe medical research in terms of its goals of advancing science and finding new medicines and treatments, sometimes in combination with helping the enrolled individuals. The majority perceive a difference between research and regular medical care and described these differences in various ways. Further exploration is warranted about how such perceived differences matter to participants and how this understanding could be used to enhance informed consent and the overall research experience. (shrink)

Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...) but future ones should. (shrink)

Aquinas’s actual response to a naturalistic challenge at ST I.2.3 is one which most naturalists would find unimpressive. However, I shall argue that there is a stronger response latent in his philosophical system. I take Quine as an example of a methodological naturalist, examine the roots of his position and look at two critical responses to his views (those of BonJour and Boghossian). If one adjusts some of the problematical aspects of their responses and establishes a hybrid position on the (...) epistemology and metaphysics of an antinaturalistic stance, it turns out to be the position Aquinas himself takes on meaning and knowledge. (shrink)

In this paper, I examine the debate about existence between deflationist analytic accounts and the ‘thicker’ conception used by Aquinas when speaking of esse. I argue that the way one evaluates the debate will depend on background philosophical assumptions and that reflection on those assumptions could constitute an account of theoretical wisdom.

Does the biography of a philosopher have any relevance to assessing their philosophy? After considering and rejecting three distinct treatments of this question, a different answer is articulated here. Distinguishing between the content and approach of a philosophical text, this article argues that biography is relevant to assessing the approach of the text in three ways: in its socio-historical context, its philosophical context, and its personal context in the life of the philosopher. Such a strategy offers new ways of comparing (...) very different texts and assessing them in terms of the aims of the philosopher writing them. (shrink)

Concerns about the influence of financial interests on research have increased, along with research dollars from pharmaceutical and other for-profit companies. Researchers’ financial ties to industry sponsors of research have also increased. Financial interests in biomedical research could influence research design, conduct, or reporting, and could compromise data integrity, participant safety, or both. Investigators’ financial ties with for-profit companies may influence reported scientific results, and may have compromised research participant safety.Disclosure is one commonly accepted method of managing financial relationships in (...) order to minimize possible threats to scientific objectivity, the safety of research participants, or public trust in the integrity of clinical research. Disclosure is presumed useful to the extent that “it gives those who would be affected, or who are otherwise in a good position to assess the risks, information they need to make their own decision.”. (shrink)

The late twentieth century has provided both reasons and occasions for reassessing just war theory as an organizing framework for the moral analysis of war. Books by G. Scott Davis, James T. Johnson, and John Kelsay, together with essays by Jeffrey Stout, Charles Butterworth, David Little, Bruce Lawrence, Courtney Campbell, and Tamara Sonn, signal a remarkable shift in war studies as they enlarge the cultural lens through which the interests and forces at play in political violence are identified and evaluated. (...) In his review of the contribution made by these texts, the author focuses on the cohesion of just war theory, the asymmetry between Christian and Islamic attitudes toward holy war, and the need to develop just war theory into a tool adequate to assist in the moral evaluation of violent conflicts within, not just between, nation-states. (shrink)

The topic of wisdom attracted much less attention in modern thought than in ancient and medieval times. However, there has been a renewal of interest in it in recent psychology and philosophy, and a variety of questions has emerged from this current work. Aquinas has a detailed and elaborate account of the wisdom which pervades his oeuvre. This paper explores that and seeks to answer some of these contemporary questions from Aquinas's perspective.

This is an exploration and analysis of Aquinas's contribution to the philosophy of religion. It examines Aquinas's contexts, his views on philosophy and theology, as well as faith and reason. His arguments for God's existence, responses to objections against God's existence and his characterization of the nature of God are examined.

This mini configurative review links theory of mind research with school-based social skills interventions to reframe theoretical understanding of ToM ability based on a conceptual mapping exercise. The review’s aim was to bridge areas of psychology and education concerned with social cognition. Research questions included: how do dependent variables in interventions designed to enhance child social-cognitive skills map onto ToM constructs empirically validated within psychology? In which ways do these mappings reframe conceptualization of ToM ability? Thirty-one studies on social-cognitive skill (...) with typically-developing children ages 3–11 were included as opposed to explicit ToM trainings in light of an identified performance plateau on ToM tasks in children. Intervention DVs mapped onto the following ToM constructs in at least 87% of studies: “Representation of Others and/or Self,” “Knowledge/Awareness of Mental States,” “Attributions/Explanations of Mental States,” “Social Competence,” “Predicting Behavior,” and “Understanding Complex Social Situations.” The absence of false-belief understanding as an intervention DV indicated a lack of direct training in ToM ability. A hierarchy to further organize the review’s ToM framework constructs as either skills or competences within the construct of ‘Representation of Others and/or Self’ is proposed. Implications for the conceptualization of ToM and social-cognitive research as well as educational practice are discussed, namely how school social skill interventions conceptualize skill along a continuum in contrast to the common artificial dichotomous assessment of ToM skill, yet the development of ToM can nevertheless be supported by the school environment. (shrink)

Paul Gregory's careful and insightful response to “Carnap and Two Dogmas of Empiricism” highlights a number of points which were underdeveloped in that paper. I think that he has brought into relief a central issue between Camap and Quine by supplying a crucial distinction. However I still maintain that Quine's assault is less than successful and that Gregory's further analysis of the debate sheds light on why this is so.

The authors of the two main articles in this supplement recognize the enormous potential of learning health care systems. Their first article argues that the development of these systems calls into question existing guidelines and practices that treat clinical care and clinical research as distinct activities. Their second article proposes to replace this traditional approach with a new framework, one intended to promote two important goals: support the transformation to a learning health care system and help to ensure the ethical (...) appropriateness of the activities carried out within such a system. To promote these goals, the authors propose a framework consisting of seven obligations. The authors are aware that their framework does not provide much guidance for promoting their second goal. At first glance, the seven obligations also might appear to offer little in the way of promoting the first goal. In what way, then, is the proposed framework novel and transformative, as the authors claim? The answer appears to lie largely in how the authors interpret the sixth obligation in the framework—the obligation to conduct learning activities. (shrink)

Several studies conducted in the 1970's by western analysts concluded that Buddhism is the main obstacle to economic development in Thailand. This view typifies the reasoning of mainstream modernization and development practices in Third World countries. Yet in recent years, Post World War II policies based upon the goal of modernization have been under attack for the environmental disasters they have generated, for their failure to improve human conditions where they have been implemented, and for their assumption that the western (...) world's high levels of production and consumption are superior to all other socio-economic possibilities. This dissertation focuses on Buddhist community and environmental action as a response to the hardships generated by modernization, and the ethical and spiritual system on which this action is based, especially as demonstrated by Thailand's forest monks. ;Chapter 1 examines traditionally accepted views of Buddhist ethics, the background against which new environmental interpretations emerge. Chapter 2 surveys the present trend of Buddhist social action, the application of Buddhist philosophy to contemporary social issues. Socially-engaged Buddhism is also considered with a view to its scriptural justification. Chapter 3 explores both the ethics and social action of Buddhism with specific reference to the conservation of nature. ;At this point in the modernization of Thailand, poverty is growing in rural areas, compounded by increasing drought and environmental adversity. At the same time, expanded corporate and governmental control over arable land and forests assumes command of the nation's remaining natural resources. Chapter 4 discusses this recent history. Chapter 5 concentrates on Thailand's conservationist forest monks, their ethical philosophy, the social and natural environments they are endeavoring to preserve or recover, and their work with villagers whose well-being is at stake. ;The concluding chapter investigates the western model of economic development, criticizing its universalizability, its underlying values, and its outcomes. I argue that the challenge to contemporary economic practices and lifestyles represented by the conservationist forest monks' revitalization of Buddhist tradition offers Thailand's rural poor the potential for a more satisfying and beneficial way of life. (shrink)

This dissertation explores the ethics of human subjects research with particular attention to how clinical research on vaccines differs from research on therapies. The major differences are rooted in the fact that the benefits of vaccines and vaccine research accrue to the community to which vaccines belong by inducing herd immunity and thereby protecting both vaccinated and unvaccinated individuals. Therapeutics have no corresponding benefit to the community, the primary beneficiary is the individual. The ethical justification for conducting vaccine research in (...) a given community therefore should include an evaluation of the risks and benefits to the community as well as to involved individuals. Respect for individuals extends to respect for communities and for individuals as members of communities. A three way partnership between investigators, the community, and the community members is suggested as an ethical foundation for vaccine research. ;This model is then applied to the particular and complex case of testing a preventive HIV vaccine. HIV is an unique virus which continues to cause extraordinary devastation worldwide. The characteristics of HIV, its transmission and epidemiology, along with unprecedented scientific possibilities present a formidable challenge to the development and testing of an HIV vaccine. Using the community model, specific suggestions are made for the ethical conduct of clinical efficacy trials of HIV preventive vaccines. (shrink)