ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

Other formats of this book available via https://openeducationalberta.ca/educationaltechnologyethics/.

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)

A core project for deep ecologists is the reformulation of the concept of self. In searching for a more inclusive understanding of self, deep ecologists often look to Buddhist philosophy, and to the Japanese Buddhist philosopher Dōgen in particular, for inspiration. I argue that, while Dōgen does share a nondualist, nonanthropocentric framework with deep ecology, his phenomenology of the self is fundamentally at odds with the expanded Self found in the deep ecology literature. I suggest, though I do not fully (...) argue for it, that Dōgen’s account of the self is more sympathetic to one version of ecofeminism than to deep ecology. (shrink)

Darwin thought that the moral sense was among the most challenging aspects of human life to account for through evolutionary explanations. This article seeks to probe the question about human uniqueness primarily from a theological perspective by focusing in depth on one distinctive moral sentiment, gratitude, particularly in the thought of Thomas Aquinas. It uses that example as a case study about how to consider the validity of arguments for human uniqueness within the broader compass of the cultural evolution of (...) sociality and morality within the human sciences, including evolutionary anthropology. Further questions about the evolution of religion surface in this discussion since gratitude, from a theological perspective, necessarily includes gratitude to God as a fundamental aspect of religious faith and practice. (shrink)

According to the Chinese military philosopher Sunzi, a military commander's actions must be “formless.” Ender Wiggin, in Ender's Game, displays this formlessness in the fact that when we try to analyze his actions we are left with a sense of confusion about his reasoning. Sunzi advocates tactics including strengthening the martial spirit of your own soldiers through rewards and punishments, targeting the enemy's martial spirit through tricks, exploiting their fear and anger to inspire or sap their abilities, and outwitting the (...) opponent through a mix of orthodox and unorthodox maneuvers. Sunzi stressed the importance of psychological self‐control, unfeeling and cold analysis driven by practical considerations, and adroit maneuvering of soldiers and formations on the battlefield. This chapter demonstrates how Ender's own military decisions can be illuminated by the writings of Sunzi and other seminal Asian philosophers like Confucius and Laozi. By these standards, Ender qualifies as a military genius. (shrink)

Psychedelic drugs such as psilocybin, LSD and DMT are known to induce powerful alterations in phenomenology. Perhaps of most philosophical and scientific interest is their capacity to disrupt and even “dissolve” one of the most primary features of normal experience: that of being a self. Such “peak” or “mystical” experiences are of increasing interest for their potentially transformative therapeutic value. While empirical research is underway, a theoretical conception of the mechanisms underpinning these experiences remains elusive. In the following paper, psychedelic-induced (...) ego-dissolution is accounted for within an active inference framework, as a collapse in the “temporal thickness” of an agent’s deep temporal model, as a result of lowered precision on high-level priors. The argument here is composed of three moves: first, a view of the self-model is proposed as arising within a temporally deep generative model of an embodied organism navigating an affordance landscape in the service of allostasis. Next, a view of the action of psychedelics as lowering the precision of high-level priors within the generative model is unpacked in terms of a high Bayesian learning rate. Finally, the relaxation of high-level priors is argued to cause a “collapse” in the temporal thickness of the generative model, resulting in a collapse in the self-model and a loss of the ordinary sense of being a self. This account has implications for our understanding of ordinary self-consciousness and disruptions in self-consciousness present in psychosis, autism, depression, and dissociative disorders. The philosophical, theoretical and therapeutic implications of this account are touched upon. (shrink)

This paper argues that the language of rights cannot express distinctively ecofeminist insights into the treatment of nonhuman animals and the environment. An alternative is proposed in the form of a politicized ecological ethic of care which can express ecofeminist insights. The paper concludes with consideration of an ecofeminist moral issue: how we choose to understand ourselves morally in relation to what we are willing to count as food. "Contextual moral vegetarianism" represents a response to a politicized ecological ethic of (...) care. (shrink)

Abstract This paper argues that a genuine engagement of Christianity with evolution needs to include a discussion of Christology. Further, it develops a particular approach to Christology through a theo-dramatic account of incarnation. The somewhat static post-Chalcedon theological categories of divine and human natures are hard to square with contemporary evolutionary accounts of human origins. Once the divine Logos is portrayed in the active categories of Wisdom it becomes easier to envisage divine and creaturely wisdom coexisting in the person of (...) Christ. I argue, in particular, that a focus on God's agency through a modified version of Hans Urs von Balthasar's account of theo-drama invites participation and affirms human agency in a way that grand narratives do not. More particularly, drawing on examples from hominid evolution, contemporary discussion of paleontology and cooperative evolutionary theories, I suggest that the most convincing accounts of evolutionary biology fit into this theo-dramatic account more readily than alternatives. As such, in the spirit of Robert Boyle, this paper deliberately blurs the categories of revealed and natural theology by arguing that we can make sense of the former through concentration on the latter. (shrink)

New Blackfriars, Volume 103, Issue 1104, Page 171-188, March 2022.

This paper offers a theological critique of the future of ‘nature’ as suggested by New Biology, including recent developments in genetic engineering. It explores the biblical basis for grounding a theology of creation in the wisdom motif. The relationship between wisdom and creation in the Old Testament is discussed. The link between wisdom, Christ and the Holy Spirit is suggestive of wisdom's involvement in re‐creation as well as initial creation. An argument is put forward for a Trinitarian basis for wisdom. (...) The relationship between wisdom and apocalyptic literature gives a clue as to how wisdom might contribute to theological reflection on the future. Wisdom as metaphor is used to construct a new future of science. By reformulating the future of creation in the light of wisdom a future of science comes into view that meets the postmodern requirement for adaptability and diversity, but without forgetting the idea of distinction between humanity and the natural world. The long tradition of wisdom brings both a rootedness in historical perspectives and dynamic flexibility that serves to inform the relationship between God and the natural world. A measure of stability is a requirement in shaping perspectives for the future, particularly if the ambivalence and anxiety associated with new explorations in science are to be met. (shrink)

In this book, David Deane proposes a renewal of Catholic moral theology by deconstructing dominant secular positions and restoring Catholic positions to their theological roots.

Delusions play a fundamental role in the history of psychology, philosophy and culture, dividing not only the mad from the sane but reason from unreason. Yet the very nature and extent of delusions are poorly understood. What are delusions? How do they differ from everyday errors or mistaken beliefs? Are they scientific categories? In this superb, panoramic investigation of delusion Jennifer Radden explores these questions and more, unravelling a fascinating story that ranges from Descartes’s demon to famous first-hand accounts (...) of delusion, such as Daniel Schreber’s Memoirs of My Nervous Illness. Radden places delusion in both a clinical and cultural context and explores a fascinating range of themes: delusions as both individually and collectively held, including the phenomenon of folies á deux ; spiritual and religious delusions, in particular what distinguishes normal religious belief from delusions with religious themes; how we assess those suffering from delusion from a moral standpoint; and how we are to interpret violent actions when they are the result of delusional thinking. As well as more common delusions, such as those of grandeur, she also discusses some of the most interesting and perplexing forms of clinical delusion, such as Cotard and Capgras. (shrink)

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

Anglophone attention to issues of race and racism, with particular attention to Kant and other members of the German Enlightenment, has long been hampered by a lack of critical editions in English. While this is no longer significantly true for Kant studies, it continues to be the case for many of the most relevant works by Georg Forster and Christoph Meiners. This is a problem for philosophers working exclusively in English, and it is one that is only exacerbated by the (...) field’s general lack of interest in not just the intellectual history of philosophy and its figures, but in analyses published in languages other than English today. Ahistorical, monolinguistic approaches become especially problematic, however, when it comes to the philosophical analysis of race and racism, given the need to approach such topics from multiple angles at once—historical, political, cultural, economic, and legal—a fact that is no less true for scholarship on the figures of the eighteenth century than it is for the study of the present one. My aim in what follows therefore is to fill in a bit of the bigger picture, the specific context within which a writer like Georg Forster and his cohort were working, in order to better frame the kinds of specialised discussions of Kant’s philosophy of race that we find today. (shrink)

Conscious states—state that there is something it is like to be in—seem both rich or full of detail and ineffable or hard to fully describe or recall. The problem of ineffability, in particular, is a longstanding issue in philosophy that partly motivates the explanatory gap: the belief that consciousness cannot be reduced to underlying physical processes. Here, we provide an information theoretic dynamical systems perspective on the richness and ineffability of consciousness. In our framework, the richness of conscious experience corresponds (...) to the amount of information in a conscious state and ineffability corresponds to the amount of information lost at different stages of processing. We describe how attractor dynamics in working memory would induce impoverished recollections of our original experiences, how the discrete symbolic nature of language is insufficient for describing the rich and high-dimensional structure of experiences, and how similarity in the cognitive function of two individuals relates to improved communicability of their experiences to each other. While our model may not settle all questions relating to the explanatory gap, it makes progress toward a fully physicalist explanation of the richness and ineffability of conscious experience—two important aspects that seem to be part of what makes qualitative character so puzzling. (shrink)

This paper considers the state of contingent laborers, Ph.D. holders, lovers of robust scholarship, and hopeful academics who toil away in the neoliberal university in the search for the academic good life. The author argues that the academic good life is a fantasy and agrees that the fantasy is cruel, i.e. not attainable or livable, but does suggest the practices of teaching and conducting research, the practices that make up a scholarly life, are sustainable activities of a good life that (...) can and should inform how we use the university. After drawing on Alasdair MacIntyre and Chris Higgins to picture the academic good life, Deane turns to theories of refusal articulated by Sandy Grande and Bonnie Honig to suggest refusal practices for reimagining lives that are academic and good. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

Health and Social Justice (Ruger 2009a) developed the ?health capability paradigm,? a conception of justice and health in domestic societies. This idea undergirds an alternative framework of social cooperation called ?shared health governance? (SHG). SHG puts forth a set of moral responsibilities, motivational aspirations, and institutional arrangements, and apportions roles for implementation in striving for health justice. This article develops further the SHG framework and explains its importance and implications for governing health domestically.

True to his longstanding bias against grand unifying theories, Hacking chooses to pursue these questions by focusing on a specific case of memory-thinking: the history of multiple personality. His excavation of the contemporary terrain leads him, however, to the surprisingly grand conclusion that the various sciences of memory—including neurological studies of localization, experimental studies of recall, and studies in the psychodynamics of memory—all emerged in connection with attempts to “scientize the soul,” as a result of which spiritual battles have been (...) recast as scientific controversies “where we suppose there is such a thing as knowledge to be had”. (shrink)

Philosophy has often been criticized for privileging the abstract; this volume attempts to remedy that situation. Focusing on one of the most concrete of human concerns, food, the editors argue for the existence of a philosophy of food.

The ethical naturalist asks us to take seriously the idea that practical norms are a species of natural norms, such that moral goodness is a kind of natural goodness. The ethical naturalist has not demonstrated, however, how it is possible for a power of reason to be governed by natural norms, because her own attempts to do this have led her into a dilemma. If she takes the first horn and stresses that ethical naturalism provides objective, natural norms of the (...) species, then she fails to show how such norms are practical, or operative from a deliberative point of view. If she takes the second horn and stresses that ethical naturalism yields a picture of knowledge of human life that is practical because it comes through virtuous dispositions of intellect and will, then she fails to have an account of how it is knowledge of facts about a life form, potentially accessible to a non-human knower. In this paper, I argue that one potential resolution to this dilemma can be found in the writings of Thomas Aquinas. On a broadly Thomist account of practical reason, the first principles of practical reason are our common human ends or goods, which are constitutive of a good human life. The work of practical reason on this naturalistic account is twofold: to conceive and order these ends into some general conception of how to live, and to apply this general conception to the particular situations of one’s life in order to realize one’s vision of the good life, here and now. (shrink)

I discuss controversial claims about the status of non-human animals as moral beings in relation to philosophical claims to the contrary. I address questions about the ontology of animals rather than ethical approaches as to how humans need to treat other animals through notions of, for example, animal rights. I explore the evolutionary origins of behavior that can be considered vices or virtues and suggest that Thomas Aquinas is closer to Darwin's view on nonhuman animals than we might suppose. An (...) appreciation of the complexity of the emotional lives of social animals and their cooperative behaviors in light of the work of animal ethologists such as Frans de Waal and Marc Bekoff suggests that social animals can be considered moral in their own terms. I discuss the charge of anthropomorphism, drawing on the work of archaeologist Steven Mithen, and consider arguments for the evolution of conscience in the work of anthropologist Christopher Boehm. Only the biological basis for the development of conscience and religion has evolved in nonhuman animals, and this should not be confused with sophisticated moral systems of analysis or particular religious beliefs found in the human community. (shrink)

The subjective deontic "ought" generates counterexamples to classical inference rules like modus ponens. It also conflicts with the orthodox view about modals and conditionals in natural language semantics. Most accounts of the subjective ought build substantive and unattractive normative assumptions into the semantics of the modal. I sketch a general semantic account, along with a metasemantic story about the context sensitivity of information-sensitive operators.

ABSTRACT Philosophers of education have written about the moral, ethical, racial, and gendered dimensions of the hidden curriculum of what we eat, who we eat with, and the significance afforded this moment of the school day. To this body of literature, we add the observation that female bodies were positioned by Jean Jacques Rousseau as necessary food for the stuff of society. We trace the ways in which Rousseau’s rendering of the natural female body have followed us into our modern (...) educational systems such that any hopes for gender equality in our educational and social structures must attend to the pervasive naturalization of the bodies – human and nonhuman – that we are taught to milk for all that they are worth. (shrink)

This article poses a challenge to contemporary theories in psychology that portray empathy as a negative force in the moral life. Instead, drawing on alternative psychological and philosophical literature, especially Martha Nussbaum, I argue that empathy is related to the virtue of compassion and therefore crucial for moral action. Evidence for evolutionary anthropological accounts of compassion in early hominins provides additional arguments for its positive value in deep human history. I discuss this work alongside Thomistic notions of practical wisdom, compassion, (...) misericordia, and the importance of reason in the moral life. The tension between “bottom up” accounts of empathy and that according to a theological interpretation of “infused” virtues also needs to be addressed. From a secular perspective, infused virtue is a projection of the ideal moral life, but from a theological perspective, it is a way of understanding how human capacities through the action of grace can reach beyond what seem to be the limits of psychological moral identity. (shrink)

Truth, Trust and Medicine investigates the notion of trust and honesty in medicine, and questions whether honesty and openness are of equal importance in maintaining the trust necessary in doctor-patient relationships. Jackson begins with the premise that those in the medical profession have a basic duty to be worthy of the trust their patients place in them. Yet questions of the ethics of withholding information and consent and covert surveillance in care units persist. This book boldly addresses these questions which (...) disturb our very modern notions of a patient's autonomy, self-determination and informed consent. (shrink)

Very little research into women farmers in developed countries has been produced by economists, but much of what has been studied by scholars in other disciplines has economic implications. This article reviews such research produced by scholars in all disciplines to explore to what extent women farmers are becoming more equal to men farmers and to suggest further contributions to the literature. As examples, topics that has been widely researched in developing countries but have received almost no attention in developed (...) countries include comparisons of men and women farmers’ productivity and their access to and use of resources. Discoveries in these and other areas will be important not only for their insights into the agricultural industry in developed countries, but also because they will inform, and be informed by, research on women farmers in developing countries. (shrink)

There are two driving questions informing this book. The first is where does our moral life come from? It presupposes that considering morality broadly is inadequate. Instead, different aspects need to be teased apart. It is not sufficient to assume that different virtues are bolted onto a vicious animality, red in tooth and claw. Nature and culture have interlaced histories. By weaving in evolutionary theories and debates on the evolution of compassion, justice and wisdom, it showa a richer account of (...) who we are as moral agents. The second driving question concerns our relationships with animals. Deane-Drummond argues for a complex community-based multispecies approach. Hence, rather than extending rights, a more radical approach is a holistic multispecies framework for moral action. This need not weaken individual responsibility. She intends not to develop a manual of practice, but rather to build towards an alternative philosophically informed approach to theological ethics, including animal ethics. The theological thread weaving through this account is wisdom. Wisdom has many different levels, and in the broadest sense is connected with the flow of life understood in its interconnectedness and sociality. It is profoundly theological and practical. In naming the project the evolution of wisdom Deane-Drummond makes a statement about where wisdom may have come from and its future orientation. But justice, compassion and conscience are not far behind, especially in so far as they are relevant to both individual decision-making and0institutions. (shrink)

Finding a way to come to terms with the disvalues in the evolutionary world is a particular challenge in the light of Neo‐Darwinian theories. In this article I trace the shift in Christopher Southgate's work from a focus on theodicy to a theologian of glory. I am critical of his rejection of the tradition of the Fall, his incorporation of disvalues into the work of divine Glory, and the specific theological weight given to scientific content. I offer a critique of (...) Holmes Rolston III's approach to the valuation of nature that I believe has influenced Southgate's theology. Constructively, I offer an alternative that seeks to recover an understanding of the origin of evil and the Adamic event that draws on the work of Paul Ricoeur. I also draw on the work of anthropologist Tim Ingold for an alternative philosophical approach to evolution which opens up a space for a recovery of the concepts of creaturely Sophia and shadow Sophia in the work of Sergius Bulgakov. (shrink)