In many countries around the world, people who inject drugs remain at high risk of HIV acquisition not because effective forms of prevention are unknown, nor because they find effective prevention undesirable, but because those in charge, mainly politicians but also bureaucrats, find evidence-based practice politically unacceptable. The evidence for preventive efficacy of harm reduction strategies, most prominently needle and syringe programmes but also treatment programmes such as opiate substitution, is irrefutable.1 However, political responses to drug use issues are varied (...) and complex, so the will to implement appropriate harm reduction programmes in the interests of public health remains lacking in too many jurisdictions. As a consequence, the discussion of how best, in the context of research, to reduce HIV incidence in populations of people who inject drugs but are not offered comprehensive access to known prevention strategies is—tragically—an important one. Dawson et al 2 focus on access to sterile injecting equipment and recognise that this should remain the ‘default’ standard of prevention for HIV prevention trials involving people for whom injecting drug use is the primary risk factor for HIV acquisition. ‘Standard of prevention’ means the background or minimal HIV risk reduction interventions offered to all participants in a trial, regardless of what other investigational interventions they are assigned to receive. The standard of prevention concept is grounded in the ethical principle of beneficence—that researchers and sponsors are obliged to maximise benefits and minimise risks to participants in research studies.3 …. (shrink)

Published data show that new HIV prevention strategies including treatment-as-prevention and pre-exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV-based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment-as-prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment-as-prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment-as-prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV-based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

Drawing on theories of social exchange and social information processing, we examined whether the influence of psychological contract breach on in-role performance and organization-directed citizenship behavior (OCBO) depends work group climate levels, specifically procedural justice climate and power distance climate. The findings supported our hypothesis that psychological contract breach exhibits a stronger influence on in-role performance and OCBO among members of units with favorable procedural justice climates. Support for a hypothesized moderating role of power distance climate was less conclusive. We (...) discuss the implications of our model and findings for theories of employee-organization relationships and practice. (shrink)

Advances in genomics have led to calls for developing population-based preventive genomic sequencing programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the (...) sequencing or analysis of specific genomic conditions or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

We propose that in pictures both the extended limbs of actors and the ground are involved in gestalts for movement. Limbs extend to suggest more motion literally when a dancer is in air and refer to a canonical pose when on the ground. A running pony’s curled limbs off the ground depict fast action literally. A horse’s flying-gallop off the ground suggests speedy motion metaphorically. Cast shadows indicate the actor’s location with respect to the ground. We consider extended and curled (...) limbs, on-ground and off, in literal and metaphoric pictures. (shrink)

Research suggests that institutions affect the levels of corruption in a country. We take these arguments a step further and examine whether it is the presence of inclusive institutions and/or the credible and consistent implementation of institutions that matter, as regards corruption. We use a novel approach to theoretically conceptualise and empirically operationalise institutions along two analytically distinct dimensions: the nature of the institutions (the de jure dimension), and the extent to which they are credibly and consistently implemented over time (...) (the de facto dimension), using a panel dataset for 148 countries covering 2012 to 2018. We find that formal institutions are most effective in reducing corruption when the rules are credibly and consistently implemented. Furthermore, this effect appears to operate differently at different levels of national income. The nature of the formal institutions appears important across income levels, but particularly so at the upper middle income level, while the credible and consistent implementation of these institutions is primarily influential at upper middle income levels. We explain why this may be the case and elaborate on the policy implications. (shrink)

Across the modern political spectrum, left-wing and right-wing political theorists have invested sport with ideological significance. That significance, however, varies distinctively and characteristically with the ideology—a phenomenon John Hoberman terms "ideological differentiation." Taking this phenomenon as its point of departure, this provocative work interprets the major sport ideologies of the twentieth century as distinct expressions of political doctrine. Hoberman argues that a political ideology's interpretation of sport is shaped in part by the value it assigns to work and play (...) as modes of experience; the political anthropologies of right and left can be distinguished by examining their resistance to—or affinity for—sportive imagery of their leaders and of the state itself; there exists a fascist temperament that shows an affinity to athleticism and the sphere of the body that is not shared by the left. Tracing modern sport ideology back to its premodern antecedents, Hoberman examines the interpretations of sport that have been promulgated by European political intellectuals, such as cultural conservatives and contemporary neo-Marxists, and by the official ideologists of Nazi Germany, the Soviet Union, the German Democratic Republic, and China before and after Mao. As a form of mass theater, sport can advertise any ideology. But the deeper relationship between sport and political ideology has never before been explored wth such vigor. Presenting the first general theory of sport and political ideology to appear in any language, Hoberman's groundbreaking work is a unique and invaluable contribution to the intellectual and political history of sport in the twentieth century. (shrink)

Bowler, Gardiner, and Grice have shown a small but significant impairment of autonoetic awareness or remembering involved in the episodic memory experiences of adults with Asperger’s syndrome. This was compensated by an increase in experiences of noetic awareness or knowing. The question remains as to whether the residual autonoetic awareness in Asperger individuals is qualitatively the same as that of typical comparison participants. Three experiments are presented in which manipulations that have shown differential effects on different kinds of conscious awareness (...) in memory in typical populations are employed with a sample of adults with Asperger’s syndrome. The results suggest that the experiences of remembering reported by such individuals, although reduced in quantity, are qualitatively similar to those seen in the typical population. The results are discussed in the context of current theories of awareness in episodic memory. (shrink)

A flurry of recent publications have challenged consensus views on the tempo and mode of plastid (chloroplast) evolution in eukaryotes and, more generally, the impact of endosymbiosis in the evolution of the nuclear genome. Endosymbiont‐to‐nucleus gene transfer is an essential component of the transition from endosymbiont to organelle, but the sheer diversity of algal‐derived genes in photosynthetic organisms such as diatoms, as well as the existence of genes of putative plastid ancestry in the nuclear genomes of plastid‐lacking eukaryotes such as (...) ciliates and choanoflagellates, defy simple explanation. Collectively, these papers underscore the power of comparative genomics and, at the same time, reveal how little we know with certainty about the earliest stages of the evolution of photosynthetic eukaryotes. Editor's suggested further reading in BioEssaysEarly steps in plastid evolution: current ideas and controversies AbstractDinoflagellate mitochondrial genomes: stretching the rules of molecular biology Abstract. (shrink)

To the Editor: Daniel Callahan is correct when, in “Rationing: Theory, Politics, and Passions”, he tells us that the combination of ever-rising medical costs and ever-increasing demand for expensive resources by physicians and their patients will—in the absence of any workable, generally acceptable mode of official rationing—lead to covert rationing. Or, more precisely, it will encourage us to extend the covert rationing that already exists, where those with more get more. As things stand now, this is unavoidable. However..

... We will turn our attention to the current state of pain relief technology and the ethical questions surrounding the use of advanced technology, otherwise referred to as "high-tech," pain relief. It is obvious that pain may decrease the quality of life for cancer patients. The availability of long-acting narcotics, such as MS Contin or methadone, affords cancer patients long-duration pain relief at minimal cost. The use of adjuvant medications may also be important. Clinical examples of the effective use of (...) adjuvant medications include the addition of a nonsteroidal, anti-inflammatory agent to help patients cope with bone pain and the use of a serotonin blocking agent to reduce the transmission of pain impulses in the spinal cord. Only a small percentage of patients are good candidates for high-tech delivery systems for narcotic administration. In our pain management clinic, all patients are initially placed on oral medications. When the side effects of oral medications become excessive, or the patient becomes unable to take oral medications, high-tech modalities are considered for use. (shrink)

Introduction -- Paradoxes -- Scientism -- Logic and meaning -- Initiate learning -- The self and I -- Trust and wonder.

The problem of ‘wayward causal chains’ threatens any causal analysis of the concept of intentional human action. For such chains show that the mere causation of an action by the right sort of belief and/or desire does not make the action intentional, i.e. one done in order to attain the object of desire. Now if the ‘because’ in ‘wayward’ action-explanations is straightforwardly causal, that might be argued to indicate by contrast that the different ‘because’ of reasons-explanations (which both explain and (...) justify) is non-causal. Myles Brand, in Intending and Acting (1984), resists this conclusion, but argues that waywardness shows that philosophers must ‘naturalize’ action theory by drawing on contemporary work in cognitive science and artificial intelligence. I argue that this is a misconceived response to the problem of waywardness: in Brand’s work action theory itself has gone astray, unsure which way to tum next. (shrink)

Recent policy debates in the US over access to mental health care have raised several philosophically complex ethical and conceptual issues. The defeat of mental health parity legislation in the US Congress has brought new urgency and relevance to theoretical and empirical investigations into the nature of mental illness and its relation to other forms of sickness and disability. Manifold, nebulous, and often competing conceptions of mental illness make the creation of coherent public policy exceedingly difficult. Referencing a variety of (...) approaches to ethical reflection on health care, and drawing from the empirical literature on therapeutic efficacy and economic efficiency, we argue that differential rationing, ‘disparity,’ is unjustifiable. (shrink)

Jacob (history, New School for Social Research) proposes that the science of the 17th and 18th centuries was eventually accepted because it was made compatible with larger political and economic interests. A celebration of the recently concluded 33 volume edition of the Collected works of John Stuart Mill, produced over a period of nearly 30 years, the last 20 under the guiding genius (and hand) of general editor Robson. Following a tributary history of the project itself, essays cover Mill's (...) career as a thinker and as a bureaucrat and public servant, exploring the effects of the various milieu--domestic, political, administrative, religious, and cultural--in which he moved. Annotation copyrighted by Book News, Inc., Portland, OR. (shrink)

So, on 22 July 1865, under the title ‘Philosophy and Punch’, did England's premier comic weekly greet the election of J. S. Mill as MP for Westminster. Mill held his seat for only one term, until the general election of 1868, when his Whig-Liberal colleague Robert Wellesley Grosvenor was re-elected, but Mill was replaced by the loser in 1865, the Conservative W. H. Smith, Jr., who, though he never went to sea, became the ruler of the Queen's navy. The reasons (...) for that reversal have engaged the attention of many, including Mill himself; I should like to introduce into the discussion material from an ignored source, the comic weeklies, which took a continued and close look at Mill's behaviour during his parliamentary years. While this evidence generally does not disconfirm earlier judgments—including my own— it does more than merely add to the induction. First, it shows how different political stances led journals to focus on different aspects of Mill's parliamentary career, and to adopt different rhetorical strategies in portraying him in picture and word. Second, it demonstrates how the hardening of party allegiances during the parliament of 1865–68, which accelerated in the preparatory campaigns for the general election of 1868, affected Mill adversely. Third, it suggests strongly that it was not his ‘crotchets’ or ‘whims’, especially women's suffrage and proportional representation, that damaged his chances for re-election, but his advocacy of causes unpopular with the majority of Liberals as well as with Conservatives. (shrink)

In this 1976 volume, Professor Ziman paints a broad picture of science, and of its relations to the world in general. He sets the scene by the historical development of scientific research as a profession, the growth of scientific technologies out of the useful arts, the sources of invention and technical innovation, and the advent of Big Science. He then discusses the economics of research and development, the connections between science and war, the nature of science policy and the moral (...) dilemmas of social responsibility in science. Each topic is introduced by reference to easily understandable particular examples, with a large number of illustrations chosen to bring out the concreteness and reality of science as a human activity. Professor Ziman gives a chapter-by-chapter list of suggested topics for oral and written discussion, intended to provoke critical, sceptical attitudes to simplified solutions to real issues, and comments briefly on relevant books and other sources. (shrink)

The Heirs of Plato is the first full study of the various directions in philosophy taken by Plato's followers in the first seventy years after his death in 347 BC - the period generally known as 'The Old Academy', unjustly neglected by historians of philosophy. Lucid and accessible, John Dillon's book provides an introductory chapter on the school itself, and a summary of Plato's philosophical heritage, before looking at each of the school heads and other chief characters, exploring both (...) what holds them together and what sets them apart. (shrink)

In this book John Ziman seeks the answers to crucial questions facing scientists who need to change the direction of their careers.

In this paper we open up the topic of ethical corporate identity: what we believe to be a new, as well as highly salient, field of inquiry for scholarship in ethics and corporate social responsibility. Taking as our starting point Balmer’s (in Balmer and Greyser, 2002) AC2ID test model of corporate identity – a pragmatic tool of identity management – we explore the specificities of an ethical form of corporate identity. We draw key insights from conceptualizations of corporate social responsibility (...) and stakeholder theory. We argue ethical identity potentially takes us beyond the personification of the corporation. Instead, ethical identity is seen to be formed relationally, between parties, within a community of business and social exchange. Extending the AC2ID test model, we suggest the management of ethical identity requires a more socially, dialogically embedded kind of corporate practice and greater levels of critical reflexivity. (shrink)