It has long been assumed that the architectural proteins of chromatin (the histones, for example) are unrelated to their functional proteins (transcription factors, polymerases, etc). New studies(1,2)drastically change this perspective. It appears that a portion of the general transcription initiation complex TFIID is made up of proteins that not only carry marked sequence and structural resemblances to the core histones of the nucleosome, but also form an octameric complex similar to the histone octamer. This can now be seen as part (...) of a general pattern of continuity among structural and functional chromatin proteins. (shrink)

Extensive studies of DNA secondary structure during the past decade have shown that DNA is a dynamic molecule, whose structure depends on the underlying nucleotide sequence and is influenced by the environment and the overall DNA topology. Three major non‐B‐DNA structures have been described (Z‐DNA, triplex DNA and cruciform DNA) which are stabilized by unconstrained negative supercoiling and can be formed under physiological conditions. In this essay we summarize the DNA primary structure features that are pertinent to the formation of (...) these conformers and present data concerning the occurrence of these sequences in the eukaryotic genome. The evidence in favor of the existence of these unusual DNA structures in vivo is discussed. The effect of alternative non‐B‐DNA structures on the way DNA is organized in chromatin is considered, and this is followed by evaluation of the data relating these structures to eukaryotic transcription. Some possible mechanisms by which the effect of non‐B structures on transcription might be exerted are proposed. (shrink)

(1992). “Attention structure” or “visual regard” as measurement of social status in groups of children. World Futures: Vol. 35, Socio-Mental Bimodality, pp. 115-139.

Background: On a day to day basis, nurses are facing more ethical dilemmas during end-of-life care resulting in not being able to actualize a good death for patients. Research objective: The purpose of this study was to explore how experienced hospice nurses resolve day to day ethical dilemmas during end-of-life care. Research design: The study used a qualitative narrative approach. Participants: Through purposeful sampling, a total of six experienced hospice nurse participated. Ethical considerations: Approval from the researcher’s university Institutional Review (...) Board for ethical review was obtained. Findings: Using core story creation, several different ethical dilemmas were identified divulging struggles with key stakeholders including family members and providers. Thematic analysis generated three main themes: Ethics within Practice, Ethical Knowledge, and Ethical Solutions. Discussion: The participants told their stories depicting a keen awareness of ethical conflicts situated by contextual factors including social, political, and personal issues. The nurses’ deliberations were informed through formal, experiential, and intuitive knowledge. Ethical predicaments were resolved by either following rules or choosing acts of resistance. Conclusion: A better understanding was obtained on how experienced hospice nurses successfully resolve ethical dilemmas culminating in better deaths for patients. (shrink)

This paper finds its origin in a debate between Georges Bataille (1897-1962) and Octavio Paz (1914-1998) on what is central to the idea of eroticism. Bataille posits that violence and transgression are fundamental to eroticism, and without prohibition, eroticism would cease to exist. Paz, however, views violence and transgression as merely intersecting with, rather than being intrinsic to, eroticism. Paz places focus on imagination, and transforms eroticism from a transgressive, to a ritualistic act. Eroticism thus functions as an intermediary, turning (...) animal sexuality into ceremony and rite. In this paper, I argue that Paz and Bataille are not fundamentally at odds in their conceptualisation of eroticism. Instead, Paz redefines the locus of eroticism by subverting its unsettling aspects. His conception of eroticism gives precedence to the imagination, which in itself is an act of violation. Imagination transgresses normal life, but this transgression – the violation of the habitual world – also introduces a glimpse of the numinous that Paz associates with belongingness. The paper further explores eroticism, as this is perceived today, and argues that it ultimately eliminates the threshold marked by transgression. The rise of the contemporary pornographic society is marked by a loss of imagination and transcendence, which ultimately reduces the subject into a mere automaton that demands instant gratification. (shrink)

Theorists have spent considerable time discussing the concept of responsibility. Their discussions, however, have generally focused on the question of who counts as responsible, and for what. But as Gary Watson has noted, “Responsibility is a triadic relationship: an individual (or group) is responsible to others for something” (Watson Agency and answerability: selected essays, 2004 , p. 7). Thus, theorizing about responsibility ought to involve theorizing not just about the actor and her conduct, but also about those the actor is (...) responsible to—and specifically about how these people hold the actor responsible for her conduct. In this paper, I give a topology of the terrain of holding others responsible. Over the course of the paper I disambiguate two very broad senses of holding responsible—regarding another as a responsible agent and holding another responsible for a particular piece of conduct. Next, I argue that the latter sense of holding responsible is a genus with two species—what I will call “holding responsible as deep moral appraisal” and “holding responsible as accountability.” Appreciating these distinctions, I argue, sheds considerable light on a number of questions concerning the scope and nature of our practices of holding others responsible. Finally, illuminating these distinct senses of holding responsible and highlighting their features reveals an awkwardness in the most carefully explicated and influential account of holding responsible, namely R. Jay Wallace’s account in Responsibility and the Moral Sentiments. (shrink)

In Holding and Psychoanalysis: A Relational Perspective, Joyce Slochower brings a contemporary relational framework to bear on Winnicott's notion of the analytic holding environment. She presents a fresh, thought-provoking, and clinically useful integration of Winnicott's seminal insights with contemporary relational and feminist/psychoanalytic contributions. Seeking to broaden the concept of holding beyond work with severely regressed patients, she addresses holding in a variety of clinical contexts and focuses especially on holding processes in relation to issues of dependence, self-involvement, and hate. She (...) also considers clinical work with patients "on the edge" - patients who seem deperately to need a holding experience that remains paradoxically elusive. Slochower begins her study by questioning the therapeutic limitations of an interactive style. There are times, she proposes, when certain patients simply cannot tolerate evidence of the analyst's separate subjective presence and instead need a holding experience. Though this holding function is essential to work with difficult patients, it enters into the treatment of all patients, whether as figure or ground. Slochower's relational understanding of holding leads her to consider the impact of holding on patient and analyst alike. Throughout, she emphasizes the analyst's and the patient's co-construction, during moments of holding, of an essential illusion of analytic attunement; this illusion serves to protect the patient from potentially disruptive aspects of the analyst's subjective presence. Slochower's case vignettes helpfully illuminate the intersubjective aspects of the holding process, including the clinical picture when a holding frame fails. She elaborates her thesis by considering the therapeutic function of holding in mourning. And she concludes her study with a cogent examination of the theoretical and clinical limitations of working with a holding process. A welcome reprise on an essential Winnicottian theme, Holding and Psychoanalysis broadens and deepens our understanding of the therapeutic role of the analyst's holding function. (shrink)

This critical reflection on the ethical concerns of current practice is underpinned by a systematic synthesis of current evidence focusing on why and how children are held or restrained for clinical procedures within acute care and the experiences of those present when a child is held against their wishes. Empirical evidence from a range of clinical settings internationally demonstrates that frequently children are held for procedures to be completed; younger children and those requiring procedures perceived as urgent are more likely (...) to be held. Parents and health professionals express how holding children for procedures can cause feelings of moral distress expressed as uncertainty, guilt and upset and that this act breaches the trusting and protective relationship established with children. Despite this, children's rights and alternatives to holding are not always respected or explored. Children's experiences and perceptions are absent from current literature. Children and young people have a moral right to have their voice and protests heard and respected and for these to inform judgements of their best interests and the actions of health professionals. Without robust evidence, debate and recognition that children are frequently held against their wishes in clinical practice for procedures which may not be urgent, children's rights will continue to be compromised. (shrink)

Winnicotts Konzept des »Holding« bezieht sich auf das komplexe psychische Tun und Wirken der Mutter für ihr neugeborenes Kind, also darauf, dass sie sowohl als »Umwelt-Mutter« als auch als »Objekt-Mutter« fungieren muss. Während das Holding mit der Umwelt-Mutter assoziiert ist, möchte ich das »Containing« hier der Objekt-Mutter zuordnen. Es soll gezeigt werden, dass Winnicott diese Konzepte in Anlehnung an Freuds frühe Beobachtungen der für die emotionale Entwicklung des Kindes entscheidenden Rolle der Mutter erarbeitete. Obwohl die Rolle des Vaters ebenso wichtig (...) sei, betonte Winnicott, es liege in der Hand der Mutter, der Psyche des Kindes die Bedeutung des Vaters nahezubringen – oder nicht. Anknüpfend an Winnicotts späte Formulierungen aus »Objektverwendung und Identifizierung« wird vorgeschlagen, dass das psychische Überleben des Objekts die entscheidende interpsychische Dynamik im Kern der Eltern-Kind-Beziehung ist. Das intrapsychisch entstehende subjektiv überlebende Objekt gewinnt im Kontext der analytischen Situation potenziell an Stärke, wenn der Analytiker imstande ist, sein Überleben zu unterstützen. Um diese Themen kreist Winnicotts Objektbeziehungstheorie. (shrink)

My dissertation defends a non-standard compatibilist position that begins with the rarely asked question, "What does it take to have a claim to exemption against other members of the moral community?". Emphasizing this question allows me to acknowledge that "true" moral responsibility is incompatible with determinism, while denying that determinism therefore undermines the legitimacy of holding people morally responsible. ;What motivates this position, in part, is the failure of leading compatibilist accounts to come to grips with the so-called problem of (...) induced desires. The problem is that such desires seem to undermine responsibility, while the most straightforward explanation for this would undermine compatibilism. Pereboom develops this problem into a powerful case for the dependence of moral responsibility on ultimate responsibility. Since the latter notion is clearly incompatible with determinism, I conclude, so is genuine moral responsibility. ;I argue that Pereboom's challenge, with slight modifications, is effective against the compatibilist accounts of Fischer and Ravizza, and R. Jay Wallace, respectively. These accounts are innovative in that they strategically withdraw the traditional compatibilist claim to free will, the better to defend a compatibilist conception of moral responsibility. I conclude that compatibilists must draw the line farther back still: not between free will and moral responsibility, but between moral responsibility and legitimately holding responsible. ;Wallace has already taken a step in this direction by making the question, "When is it appropriate to hold someone morally responsible?" prior to that of, "When is someone morally responsible?" But, I argue, successfully meeting Pereboom's challenge requires understanding this question in terms of when someone has a legitimate claim to exemption against others, and then arguing that this requires more than just not being responsible. In some cases, I suggest, the demand for exemption can compound the presumption of insufficient moral concern created by the initial breach, and that when this happens, the moral community is within its rights to reject the demand. (shrink)

In matters of responsibility, there are often two sides to the transaction: one party who holds another responsible, and the other who takes responsibility for her conduct. The first side has been closely scrutinized in discussions of the nature of responsibility, due to the influential Strawsonian conjecture that an agent is responsible if and only if it is appropriate to hold her responsible. This preoccupation with holding responsible – with its focus on the second-personal perspective and on responses like blame (...) – contrasts with a relative neglect of the perspective of the agent and the role that she has to play by taking responsibility. I aim to show that this neglect is undeserved – that taking responsibility is both distinct in character from holding responsible and fundamentally important in its own right. I develop a conception of taking responsibility that reveals an under-explored dimension of our responsibility practices. (shrink)

Rationale, aims and objectives : Evidence-based medicine (EBM) claims to be based on 'evidence', rather than 'intuition'. However, EBM's fundamental distinction between quantitative 'evidence' and qualitative 'intuition' is not self-evident. The meaning of 'evidence' is unclear and no studies of quality exist to demonstrate the superiority of EBM in health care settings. This paper argues that, despite itself, EBM holds out only the illusion of conclusive scientific rigour for clinical decision making, and that EBM ultimately is unable to fulfil its (...) own structural criteria for 'evidence'. Methods : Our deconstructive analysis of EBM draws on the work of the French philosopher, Jacques Derrida. Deconstruction works in the name of justice to lay bare, to expose what has been hidden from view. In plain language, we deconstruct EBM's paradigm of 'evidence', the randomized controlled trial (RCT), to demonstrate that there cannot be incontrovertible evidence for EBM as such. We argue that EBM therefore 'auto-deconstructs' its own paradigm, and that medical practitioners, policymakers and patients alike ought to be aware of this failure within EBM itself. Results : EBM's strict distinction between admissible evidence (based on RCTs) and other supposedly inadmissible evidence is not itself based on evidence, but rather, on intuition. In other words, according to EBM's own logic, there can be no 'evidentiary' basis for its distinction between admissible and inadmissible evidence. Ultimately, to uphold this fundamental distinction, EBM must seek recourse in (bio)political ideology and an epistemology akin to faith. (shrink)

An alethic holding is any speech act that functions to hold another person to acting for reasons that they already had prior to the performance of a speech act with this function. Although it is tempting to think of such acts as either informing another person of extant reasons for acting or as creating new reasons for that person to so act, a central goal of this paper is to suggest that this temptation should be resisted. First, alethic speech acts (...) are situated within the broader terrain of performances that strive to hold others responsible. Second, the precise sense of ‘holding’ to reason that characterizes an alethic speech act is explicated, in a manner that distinguishes such acts from either those designed to inform one of extant norms or to add new norms. Third, an account that attempts to explain how a speech act can achieve this holding function is offered, one based on the idea of a self-conscious interpersonal, transaction. Finally, it is suggested that the terrain of holding other’s responsible sketched at the outset looks different once this account of alethic holdings is in view. (shrink)

This chapter contains sections titled: Practical Ethics Practical Ethics and Hold Manufacturing Reason 1: Rock Modification is Acceptable Only for Safety Reasons Reason 2: Hold Manufacturing Violates Important Environmental Commitments Reason 3: Hold Manufacturing Harms Future Generations of Good Climbers Reason 4: This is a Slippery Slope; Any Acceptance of Manufacturing Will Lead to Abuses Conclusion.

This book explores the social practice of holding each other in our identities, beginning with pregnancy and on through the life span. Lindemann argues that our identities give us our sense of how to act and how to treat others, and that the ways in which we we hold each other in them is of crucial moral importance.

In recent years, much attention has been paid to how older people living at home can remain independent and manage their illness themselves, while less attention has been given to those who have become frail and need assistance with challenges of everyday life. In this article, I drew on Latimer's formulation of care for frail older people as relational and world‐making and on Foucault's work related to the care of the self in developing an understanding of how frail older persons (...) manage to live well at home in the final years of their lives. I use data from an ethnographic study of home care nursing in the homes of 15 frail older people to develop an understanding of how their care at home can be developed. The participants were holding on to life, which reflected their vitality and vulnerability as well as agency in continuing to explore ways to preserve and build their world at home. With declining ability and stamina relations with material things, relatives and official care workers become of central importance in holding on to life. Home care services can be thought of as part of life, as world‐forming, where workers contribute to daily activities that support living well at home. (shrink)

This essay maintains that although We Hold These Truths represented an important milestone in Catholic reflection on the American regime, Murray’s analysis of public morality and the state’s role in its promotion and enforcement is notably weak and of little assistance to us today. More specifically, it argues that Murray’s analysis is insufficiently philosophical and too concerned with the pragmatic task of forging an approach widely acceptable in the America of his day; that it rests on an artificial distinction between (...) “private” and “public” morality that fails to sufficiently appreciate the essential dependence of sound morals legislation upon the government’s recognition of moral truth; and that it too closely identifies the whole of law’s competence with the scope of its coercive jurisdiction, thus failing to appreciate the directive and educative properties of law and its role in the establishment of conditions conducive to human flourishing. (shrink)

This essay explores the project undertaken by Murray in We Hold These Truths and its relevance to contemporary America. When it first appeared in 1960, We Hold These Truths made a powerful case to the American public for the compatibility of Catholicism and American democracy and of the need for a renewal of America’s historic public consensus rooted in natural law. It also emphasized the role that the Catholic political tradition could play in this renewal. Although parts of its argument (...) may be problematic, and vast changes in America’s cultural and religious landscape make it dated in some respects, five decades after its original publication, Murray’s book nevertheless remains highly relevant to our contemporary situation, both as a contribution to democratic theory and as a profound reflection on the nature of “the civilization of the pluralist society.”. (shrink)

This essay explores “the metaphysics of American ideas” and the strengths and weaknesses of Murray’s argument in We Hold These Truths. The philosophical principles that animate the American founding, it argues, presuppose a particular understanding of the structure of being whose roots are biblical in inspiration. Murray’s account, it continues, calls our attention to the many links between the American founding and the Catholic tradition, suggests ways in which Catholic thought can give us a deeper understanding of the “truths” informing (...) the Founding, and illuminates the gulf between contemporary America’s secular “superculture” and the many cultures of local America. Expressing some concerns about the conceptions of reason, nature, and grace that inform Murray’s thought, and of Murray’s engagement with the thought of the American founders, it concludes by attempting to extend We Hold These Truths’ argument by identifying three truths, over and above those identified by Murray, that are essential to a proper understanding of the American democratic experiment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Holding Psychopaths ResponsibleMatt Matravers (bio)Keywordspsychopathy, responsibility, meta-ethics, blameILevy's interesting paper seeks to resolve the issue of the psychopath's moral responsibility in a way that avoids traditional meta-ethical debates. In what follows, I take issue both with the substantive arguments he offers about the responsibility of psychopaths and with whether those arguments can be completed while avoiding meta-ethics.I shall take it for granted that psychopathy is a genuine phenomenon and (...) that it is of the kind described by Levy. Moreover, I am sympathetic to Levy's claim that addressing the moral responsibility of psychopaths is not best done by starting with meta-ethical debates about the capacities relevant to moral responsibility in general. However, because I think that these debates come back to haunt Levy's arguments, it is worth saying a little more about the role meta-ethical considerations have had in discussions of psychopathy.The core question is this: "Are psychopaths properly held morally responsible?" It seems an obvious way to go about answering this question either to ask what capacities are needed for moral responsibility and then check whether psychopaths possess them, or to ask what capacities psychopaths possess (or lack) and then check the relevance of those capacities to moral responsibility. Either way, the method juxtaposes a list of the capacities needed for moral responsibility and a list of the capacities possessed (or lacked) by psychopaths and then simply asks whether the lists match in relevant respects.Although it seems that this must be the right approach, it has a serious flaw, which is that there is no agreement—and little prospect of agreement—among moral philosophers on what capacities are critical for moral responsibility. Kantian political philosophers connect morality with a certain kind of practical reasoning and thus think that whether psychopaths are morally responsible will turn on whether they possess some purely intellectual incapacity. Humeans, by contrast, relate morality to emotional responses and thus think the critical issue is whether psychopaths possess a capacity for "sympathy." Finally, Aristotelians think that a proper grasp of morality requires a combination of intellectual and emotional capacities.As Levy remarks, "we cannot settle a disputed question [the moral responsibility of psychopaths] by invoking principles [in this case meta-ethical principles] that are even more controversial than the original question" (2007, p. 130). That is right. Levy's response is to try to settle the 'original question' without recourse to controversial meta-ethical issues. For obvious reasons, it would be a neat trick if it could be done. For reasons given below, I do not think that it can.Levy's paper relies on a number of arguments. Two are of particular importance: First, that what [End Page 139] characterizes psychopathy is an inability to distinguish moral from conventional transgressions such that "all offences are merely conventional" (2007, p. 132); and, second, that psychopaths are not responsible for becoming psychopathic (they have a causal history of a certain kind).IIThe first of these arguments is presented around interesting empirical findings that do, indeed, suggest that psychopaths think of all transgressions as breaking conventional rules and that they do not appreciate the distinction between such transgressions and those that are, we might say, mala in se, or moral rather than conventional. Levy moves extremely quickly in concluding from this that the moral responsibility of psychopaths is significantly reduced. The argument is as follows: (i) "psychopaths … take harm to others to be wrong only because such harms are against the rules." (ii) "But, the kind and degree of wrongness, and therefore blame, which attaches to infringements of … rules is very different, and usually much less significant, than the kind and degree attaching to moral wrongs." From these two premises, Levy concludes (iii) "their degree of responsibility is smaller, arguably much smaller, than it would be for a comparable harm committed by a normal agent" (2007, p. 132).As an aside, it is not obvious whether the distinction between moral and conventional rules is, in itself, of any great significance. Rather, moral rules generally cover more serious wrongs (malicious wounding is a more serious wrong than insulting one's aunt's... (shrink)

We examine initial public offering (IPO) holdings in the mutual funds of four large investment banks and five large non-investment banks during the period 1997 through 2002. Investment banks hold IPOs with different characteristics than IPOs held by noninvestment banks, and they also tend to hold IPOs in different types of funds than non-investment banks. We classify holdings as to whether the IPO lies outside or inside the fund's objective. Investment banks hold IPOs outside the fund objective in 27% of (...) the fund/IPO pairs while non-investment banks hold outside their objective in just 5.4% of fund/IPO pairs. We see significant differences in IPO underpricing for both groups as well. For example, when non-investment banks hold IPOs outside a large capitalization fund objective, they select IPOs with 52% higher underpricing as measured by first-day returns. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 42.1 (2004) 100-101 [Access article in PDF] Kathy Eden. Friends Hold All Things in Common: Tradition, Intellectual Property, and the Adages of Erasmus. New Haven, CT: Yale University Press, 2001. Pp. ix + 194. Cloth, $35.00. When Erasmus returned from England to the continent in 1500 almost all his money was confiscated before he embarked, although his patron, Lord Mountjoy, had assured him (...) that customs regulations applied only to English currency. Upon his arrival in Paris—poor as a church mouse and feeling rather unwell—he immediately set out writing a new gift for his patron, lest Mountjoy would assume that the humanist was angry with him. A few days later Erasmus had gathered a modest collection of 818 proverbs or adagia, a "treasury or storehouse of the accumulated wealth of classical antiquity collected for common use and thus one of his principal contributions to a cultural program for cooperation," as Kathy Eden defines them (4); not a material but an intellectual wealth, a wisdom transmitted throughout generations and civilizations in the form of proverbs.This Adagiorum Collectanea became a bestseller because it provided both humanists and careerists with numerous bon mots to embellish their (Latin) style and to enhance their arguments. During his first visit to Italy Erasmus spent a few months in the household of the famous humanist and printer Aldus Manutius in Venice. This resulted in a reissue in [End Page 100] 1508 of what was now entitled Adagiorum chiliades, since the collection had been expounded to 3260 proverbs. It opened with 'Friends hold all things in common', an ancient wisdom acknowledging the commonality between friendship and property. Eight more official editions came from the press with an ever-increasing number of adagia, up to 4151 in the final edition, published as volume two of the collected works (Basle: Froben, 1536). Erasmus kept also enlarging the entries themselves, some of them becoming small essays—for instance, the famous Festina lente (Adag. II i 1) or the equally well-known Dulce bellum inexpertis (Adag. IV i 1)—which were even republished separately.In her introduction to Friends Hold All Things in Common Kathy Eden gives a quick survey of the genesis of the Adagia referring her readers for further information to more specific studies on the topic. In keeping with the opening adage she focuses on the ancient philosophical tradition that Erasmus claims as his intellectual inheritance from the past, a tradition rooted in the legal transfer of property. The humanist inherits his understanding of both friendship and property from an ancient philosophical tradition going back to Pythagoras and Plato, as well as Aristotle and Cicero. This pagan tradition is confronted and linked with the concepts of early-Christian writers, such as Tertullian, Origen, Jerome, Basil and Augustine. Not only is there a similarity between some ideas of pagan philosophers and Christian thinkers; they can even be a source of inspiration to pious living. The publication of the Adages also reflected changing attitudes and practices concerning property: thanks to the press of Manutius in Venice (and later of Frobenius in Basle), an increasing number of people was able to appropriate the heritage of classical wisdom, which had hitherto been the intellectual property of only very few. It was precisely in Venice, around the transition from the fifteenth to the sixteenth century, that the first laws regarding intellectual property—be it copyright of the author or protection of the printer's efforts—began to make an occurrence.The author proves to be well-read in both classical, biblical and patrologic sources—I particularly appreciated her combinations and confrontations of pagan and Christian sources. Of course, she is thoroughly familiar with Erasmus's Adagia, too, with an occasional excursion towards his other pedagogical treatises, such as the Antibarbarus, the Enchiridion or the Paraclesis, an adhortation to study Christian philosophy.Friends Hold All Things in Common is a carefully edited publication with hardly any noticeable language or printing errors. As a classicist I feel slightly disappointed... (shrink)

We often hold others responsible, and are held responsible ourselves. Many philosophers claim that to evaluate such holdings, we must consider the standing of the holder. Many also claim that both hypocrites and meddlers lack standing. Little has been said, however, about what exactly standing is—about what it is that hypocrites and meddlers are supposed to lack. Though talk of standing is now widespread, ‘we do not,’ in Joseph Raz’s words, ‘have an unproblematic grasp of the phenomena referred to’ by (...) such talk. In this paper I attempt to improve that grasp. I offer an account of what it is to have, and lack, standing to hold others responsible. And I offer some reasons why, if this account is accepted, both hypocrites and meddlers should lack standing. (shrink)

This paper seeks to address research governance by highlighting the notion of public accountability as a complementary tool for the establishment of an ethical resonance space for emerging technologies. Public accountability can render development and design process of emerging technologies transparent through practices of holding those in charge of research accountable for their actions, thereby fostering ethical engagement with their potential negative consequences or side-effects. Through practices such as parliamentary questions, audits, and open letters emerging technologies could be effectively rendered (...) transparent and opened up to broader levels of scrutiny and debate, thereby contributing to a greater adherence of emerging technologies to ethics and moral consensus. Fundamental democratic practices could thus not only lead to better informed choices in design and development processes, but also contribute to more morally substantive outcomes. (shrink)

A crucial question for egalitarians, and theorists of distributive justice in general, is whether people can be held responsible for disadvantages they bring upon themselves. One response to this question states that it would be inegalitarian to hold people responsible on the basis of their actions if their actions are not ultimately under their control and reflect instead the good or bad luck the agent had in being the type of person who happens to act in a given way. I (...) argue that even if we accept that there is something inegalitarian about holding people responsible on the basis of actions they did not ultimately control, the alternative (that is, not holding people responsible) is even more inegalitarian. Therefore, egalitarians, including so-called luck egalitarians, can and should hold people responsible on the basis of their actions, even if people lack free will and their actions are ultimately a matter of luck. Key Words: responsibility • egalitarianism • luck egalitarianism • fairness • distributive justice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Holding Doctors Responsible at Guantánamo*Nancy Sherman (bio)I recently visited the Guantánamo Bay Detention Center with a small group of civilian psychiatrists, psychologists, top military doctors, and Department of Defense health affairs officials to discuss detainee medical and mental health care. The unspoken reason for the invitation to go on this unusual day trip was the bruising criticism the Bush administration has received for its use of psychiatrists and psychologists (...) in the interrogation of suspected terrorist detainees.1We disembarked from our Navy jet to find an island lush and green from recent storms. A small boat took us from the airfield to the naval hospital. From the boat there was no sign of Camp Delta, where the detainees are actually held. Nor was there a sign of prisons or barbed wire or the detention facility's 505 inmates.Our host was the commanding officer of Gitmo, Major General Jay W. Hood (an artillery officer by training), who had replaced Major General Geoffrey Miller, implicated in the "migration" of torture methods from Gitmo to Abu Ghraib. Dressed in fatigues, General Hood briefed us using PowerPoint. His intelligence director told us that interrogators have not used harsh "fear up" tactics—the ones designed to terrify—since 2003.We went by bus from the naval hospital to the 30-bed detainee hospital for quick briefings from a psychiatrist and a physician. Still, we were not permitted to see any detainees or hunger strikers, despite our requests. During our six hours on the ground, we had only a fleeting glimpse of a few detainees outside their cellblocks behind barbed wire and screened fences.Indeed, when I got home and saw the play "Guantánamo: Honor Bound to Defend Freedom," by Victoria Brittain and Gillian Slovo, I had the disquieting feeling that I had absorbed more about detainee life at the theater than I had from actually being at Gitmo. This only amplified my anxiety that what I had heard and seen during my VIP visit sidestepped the central moral issue of whether abuse is still occurring at Gitmo and whether health professionals are, or have been, a party to coercive interrogation. [End Page 199]The question that the Pentagon leadership has been focusing on, and which was a key subject of discussion during our day at Gitmo, is whether there is an ethical difference between using psychologists or psychiatrists on interrogation teams—what the Pentagon calls, "behavioral consultation teams," or BSCTs, pronounced "biscuit." Some in the Pentagon would like to have doctors and psychiatrists, who are bound by the Hippocratic teaching to "do no harm," be the clinicians treating detainees. Psychologists, who are not as bound by Hippocratic dicta, would consult with and advise interrogators. But this is a red herring. It is hair-splitting that detracts from the real issue of whether health professionals of any stripe can ethically be involved in interrogations that may involve coercive techniques or torture. The answer is clearly no. They should not be involved, directly or indirectly, in situations that may lead to the breach of confidential medical records; to torture or to cruel, inhumane, and degrading treatment; or to exploitation of fears or phobias. Mental health professionals simply should not be collaborating with interrogators in inflicting psychological torture.Hood said that "rapport building" was the preferred and an effective interrogation technique, but that is no guarantee that rougher tactics will not be used. The fact is that there is enormous pressure on the people at Guantánamo Bay to get good intelligence for the war on terror, and it is as easy for behavioral scientists as it is for interrogators to compromise their moral standards. Cunning and deception to extract information may be acceptable in some cases. But many people have been outraged to learn from media reports that methods developed by military psychologists to train our own troops to resist torture—the so-called "survival, evasion, resistance, and escape" methods taught at Ft. Bragg—have been "reverse engineered" at Guantánamo Bay to create coercive, psychologically manipulative interrogation techniques for use against detainees.Plato warned long ago that a doctor's skill, abstracted from good character and wisdom, is a neutral... (shrink)

Holding On to Reality is a brilliant history of information, from its inception in the natural world to its role in the transformation of culture to the current Internet mania and is attendant assets and liabilities. Drawing on the history of ideas, the details of information technology, and the boundaries of the human condition, Borgmann illuminates the relationship between things and signs, between reality and information. "[Borgmann] has offered a stunningly clear definition of information in Holding On to Reality.... He (...) leaves room for little argument, unless one wants to pose the now vogue objection: I guess it depends on what you mean by nothing."—Paul Bennett, Wired "A superb anecdotal analysis of information for a hype-addled age."—New Scientist "This insightful and poetic reflection on the changing nature of information is a wonderful antidote to much of the current hype about the 'information revolution.' Borgmann reminds us that whatever the reality of our time, we need 'a balance of signs and things' in our lives."—Margaret Wertheim, LA Weekly. (shrink)

My colleagues and I had been asked by a member of a clinical team to help sort through the ethics of stopping a life-sustaining intervention for a very ill child. We had already talked with the parents, the physicians, and the folks from nursing, social work, and chaplaincy. Terms like “suffering,” “cruel,” “compassion,” and “moral distress” had been uttered, as had terms like “inappropriate,” “unethical,” “neglectful,” and “risk-management.” The group had now stuffed all of these polarizing thoughts and feelings into (...) this cramped room with only one door. And everyone was looking at me. What skill, competency, or inner capacity must one possess to hold and manage such tension? (shrink)

There is a tension with regard to regulative norms of inquiry. One’s commitments must survive critical scrutiny, and if they do not survive, they should be revised. Alternately, for views to be adequately articulated and defended, their proponents must maintain a strong commitment to the views in question. A solution is proposed with the notion of holding one’s own as the virtue of being reason-responsive with the prospects of improving the view in question.

Tort and contract law have not kept pace with the stunning changes in medicine's economics. Physicians are still expected to deliver the same standard of care to everyone, regardless whether it is paid for. Health plans increasingly face liability for unfortunate outcomes, even those stemming from society's mandate to keep costs down while improving population health. This book sorts through the chaos. After reviewing the inadequacies of current tort and contract law, Morreim proposes that an intelligent assignment of legal liability (...) must rest on an intelligent division of labor between health plans and providers, beginning with the question "who should be doing what, for the best delivery of health care." She also provides a comprehensive reference source of case law, commentary, and empirical literature. (shrink)

Objective: To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK. Design: Qualitative study using focus groups (10) and interviews (13). Setting: England and Northern Ireland. Participants: 68 people with MS, neurologists, MS nurses, health services management professionals, researchers, representatives from pharmaceutical companies and social care professionals. Results: People with MS expressed open and altruistic views towards the use of their personal (...) information to facilitate service provision and research, placing trust in responsible guardianship and legitimate use of their information. Participant’s proposed that people with MS should be able to select their individual level of involvement in a register using levels of consent. It was agreed that access to the register should be governed by a guardianship committee composed of a range of stakeholders. People with MS did not wish their details to be used by marketing agencies and did not consider this a legitimate use of their data. Whilst participants were positive of the role a register could play in promoting research, participants felt that access to data by pharmaceutical industries should be administered by the guardianship committee. People with MS are concerned should their employers be able to access their personal information. Professionals were more cautious than people with MS in their approach to the use of patient personal data within a register. Conclusions: Whilst all stakeholders were positive of the benefits of an MS register, development of such a resource must incorporate robust data security and guardianship measures in order to ensure that, whilst opportunities are maximised, risks to the privacy of individuals and legal challenges to professionals are avoided. (shrink)