Ethics dumping is the practice of undertaking research in a low- or middle-income setting which would not be permitted, or would be severely restricted, in a high-income setting. Whilst Kenya operates a sophisticated research governance system, resource constraints and the relatively low number of accredited research ethics committees limit the capacity for ensuring ethical compliance. As a result, Kenya has been experiencing cases of ethics dumping. This article presents 11 challenges in the context of preventing ethics dumping in Kenya, namely (...) variations in governance standards, resistance to double ethics review, resource constraints, unresolved issues in the management of biological samples, unresolved issues in the management of primary data, unsuitable informed consent procedures, cultural insensitivity, differing standards of care, reluctance to provide feedback to research communities, power differentials which facilitate the exploitation of local researchers and lack of local relevance and/or affordability of the resultant products. A reflective approach for researchers, built around the values of fairness, respect, care and honesty, is presented as a means of taking shared responsibility for preventing ethics dumping. (shrink)

There is an increasing recognition internationally of the critical impact of communication within healthcare. The link between ineffective communication, patient dissatisfaction and critical incidents is well established. Family Planning New South Wales has sought to address patient-centred care and communication in its policy platform. This article reports on research conducted within FPNSW, which analysed the discourse features that constituted effective doctor–patient1 communication in sexual and reproductive health consultations. The principal aim of the research was to understand how effectively messages were (...) conveyed and received and to what degree patients were active participants in their own sexual healthcare. Analysed consultations were characterised by extremely high levels of communicative competence on the part of the doctors who integrated medical expertise with the development of interpersonal relationships with patients, thus positioning patients as active contributors to the consultations and to decisions about their ongoing treatment. The detailed linguistic analysis identified characteristic features of patient-centred communication that are essential to patient-centred care. These interactions demonstrate that communicating care is just as important as delivering care and involves a drawing together of the medical and the interpersonal in consultations. The article details strategies for interweaving medical knowledge and establishing rapport that can inform practitioner communication practices across different healthcare contexts. (shrink)

Freedom and the Rule of Law takes a critical look at the historical beginnings of law in the United States, and how that history has influenced current trends regarding law and freedom. Anthony Peacock has compiled articles that examine the relationship between freedom and the rule of law in America. The rule of law is fundamental to all liberal constitutional regimes whose political orders recognize the equal natural rights of all.

Background and aim: Professional values are abstract and general behavioral principles that provide basic standards to judge aims and actions, and these principles are formed by strong emotional loyalty of members of the profession. Research was conducted to compare the career choice and professional values of nursing students at two universities in the upper Midwest of the United States and in the middle of Turkey. Materials and Methods: A descriptive and comparative design was used. The participants of the study were (...) comprised nursing students from a university in the upper Midwest of United States and a university in the middle of Turkey. The sample consisted of 728 students in all grades. Data were collected by a questionnaire, The Nurses Professional Values Scale–Revised and Vocational Choices in Entering Nursing Scale. Number, percentage distribution, mean, standard deviation, t test, and one-way variance analysis were used in the analysis of data. Ethical considerations: Ethical approval was obtained from the Ethics Commission. Informed consent was received from the students. Results: The students’ mean age for American students was 24.3 ± 5.6 years, while the mean age for Turkish students was 19.8 ± 1.7 years. Mean score of American students on The Vocational Congruency (a subgroup of the Vocational Choices in Entering Nursing Scale) was 38.5 ± 5.9 and Turkish students was 29.6 ± 8.9 (p < 0.05). Mean score of American students on The Nurses Professional Values Scale–Revised was 109.2 ± 12.3 and that of Turkish students was 101.6 ± 17.0. Conclusion: This study concluded that the majority of nursing students had high professional values, and when students’ scores were compared, American students had higher professional values, and in career choice, they considered primarily fitness of the profession to themselves and their goals, while Turkish students primarily thought of their living conditions. (shrink)

Researchers have proposed that blocking facial feedback via glabellar-region botulinum toxin injections can reduce depression. Random-effects meta-analyses of studies that administered GBTX...

University students are at elevated risk for psychological distress, especially during the COVID-19 pandemic. The aim of this study was to warmly contact our students and investigate the psychological impact of the COVID-19 pandemic on the subjective wellbeing and levels of psychological symptoms of university students in Belgium. All bachelor and master students of the Vrije Universiteit Brussels were invited for a brief structured telephone interview in March, 2021. In total, 7,154 students were assessed by a structured interview, based on (...) the Kessler Psychological Distress Scale and the Anamnestic Comparative Self-Assessment. Compared to a representative sample, students considered their life during the pandemic as less satisfying compared to their life before the pandemic. Overall, all students have suffered from COVID-19 and the measures taken to contain the pandemic. Twenty percent of our sample of 7,154 VUB students scored above the K6 cutoff, indicating a heightened risk for having a diagnosable mental illness severe enough to cause functional limitations and to require treatment. This study highlights the need for psychological support for all students, during the COVID-19 pandemic. (shrink)

The failure to maintain a canonical Christian understanding of the family as a microcosm of the church oriented toward deification instead of a microcosm of society aimed at social ends has opened Christians up to an uncritical adoption of non-Christian approaches in medical decision making. This article begins by identifying the Christian family crisis not as a liberal versus conservative debate centered on the form and function of the family, but more fundamentally as an ecclesial versus sociological understanding of the (...) Christian family. The article presents a historical sketch of the circumstances that have led to this contemporary crisis in the Western Christian family, followed by an analysis that provides a canonical account of the Christian family as exemplified in the thought of Gregory the Theologian. This article concludes by looking at the specific issue of labor and delivery in the United States, and the implications for a canonical Christian understanding of labor and delivery in light of contemporary medical practices. (shrink)

Ulysses is certainly the greatest novel in the English language, and one might argue for its being the greatest single work of art in our tradition. How significant, then, and how teasing, that this masterwork should be a comedy, and that its creator should have explicitly valued the comic "vision" over the tragic—how disturbing to our predilection for order that, with an homage paid to classical antiquity so meticulous that it is surely a burlesque, Joyce's exhibitionististicicity is never so (...) serious as when it is most outrageously comic. Joyce might have been addressing his readers when he wrote to Nora in 1909: "Now . . . I want you to read over and over all I have written to you. Some of it is ugly, obscene, and bestial, some of it is pure and holy and spiritual: all of it is myself." Joyce Carol Oates is the author of, among others, them, Wonderland, and The Assassins. "Jocoserious Joyce" is part of a book on tragedy and comedy. Her contributions to Critical Inquiry, include "Lawrence's Gotterdammerung" and “The Picture of Dorian Gray: Wilde's Parable about the Fall". (shrink)

Objective: To examine lay persons’ ability to identify methods of random allocation and their acceptability of using methods of random allocation in a clinical trial context.Design: Leaflets containing hypothetical medical, non-medical, and clinical trial scenarios involving random allocation, using material from guidelines for trial information leaflets.Setting and participants: Adults attending further education colleges , covering a wide range of ages, occupations, and levels of education.Main measures: Judgements of whether each of five methods of allocation to two groups was random in (...) a medical or non-medical scenario. Judgements of whether these allocation methods were acceptable in a randomised clinical trial scenario, with or without a scientific justification for randomisation.Results: The majority of our group of participants judged correctly that allowing people their preference was not random, and that the following were random: using a computer with no information about the individual , tossing a coin, drawing a name out of a hat. Judgements were split over allocating people in turn . Judgements were no different in medical and non-medical scenarios. Few of the correctly identified random methods were judged to be acceptable in a clinical trial scenario. Inclusion of a scientific justification for randomising significantly increased the acceptability of only one random method: allocation by computer.Conclusions: Current UK guidelines’ recommended description of random allocation by computer seems warranted. However, while potential trial participants may understand what random allocation means, they may find it unacceptable unless offered an acceptable justification for its use. (shrink)

Moral thinking pervades our practical lives, but where did this way of thinking come from, and what purpose does it serve? Is it to be explained by environmental pressures on our ancestors a million years ago, or is it a cultural invention of more recent origin? In The Evolution of Morality, Richard Joyce takes up these controversial questions, finding that the evidence supports an innate basis to human morality. As a moral philosopher, Joyce is interested in whether any (...) implications follow from this hypothesis. Might the fact that the human brain has been biologically prepared by natural selection to engage in moral judgment serve in some sense to vindicate this way of thinking--staving off the threat of moral skepticism, or even undergirding some version of moral realism? Or if morality has an adaptive explanation in genetic terms--if it is, as Joyce writes, "just something that helped our ancestors make more babies"--might such an explanation actually undermine morality's central role in our lives? He carefully examines both the evolutionary "vindication of morality" and the evolutionary "debunking of morality," considering the skeptical view more seriously than have others who have treated the subject.Interdisciplinary and combining the latest results from the empirical sciences with philosophical discussion, The Evolution of Morality is one of the few books in this area written from the perspective of moral philosophy. Concise and without technical jargon, the arguments are rigorous but accessible to readers from different academic backgrounds. Joyce discusses complex issues in plain language while advocating subtle and sometimes radical views. The Evolution of Morality lays the philosophical foundations for further research into the biological understanding of human morality. (shrink)

Recent years have seen a renewed debate over the importance of groupselection, especially as it relates to the evolution of altruism. Onefeature of this debate has been disagreement over which kinds ofprocesses should be described in terms of selection at multiple levels,within and between groups. Adapting some earlier discussions, we presenta mathematical framework that can be used to explore the exactrelationships between evolutionary models that do, and those that donot, explicitly recognize biological groups as fitness-bearing entities.We show a fundamental set (...) of mathematical equivalences between these twokinds of models, one of which applies a form of multi-level selectiontheory and the other being a form of ``individualism.'' However, we alsoargue that each type of model can have heuristic advantages over theother. Indeed, it can be positively useful to engage in a kind ofback-and-forth switching between two different perspectives on theevolutionary role of groups. So the position we defend is a``gestalt-switching pluralism.''. (shrink)

In The Myth of Morality, Richard Joyce argues that moral discourse is hopelessly flawed. At the heart of ordinary moral judgements is a notion of moral inescapability, or practical authority, which, upon investigation, cannot be reasonably defended. Joyce argues that natural selection is to blame, in that it has provided us with a tendency to invest the world with values that it does not contain, and demands that it does not make. Should we therefore do away with morality, (...) as we did away with other faulty notions such as witches? Possibly not. We may be able to carry on with morality as a 'useful fiction' - allowing it to have a regulative influence on our lives and decisions, perhaps even playing a central role - while not committing ourselves to believing or asserting falsehoods, and thus not being subject to accusations of 'error'. (shrink)

There is a perennial philosophical dream of a certain natural order for the natural kinds. The name of this dream is ‘the hierarchy requirement’. According to this postulate, proper natural kinds form a taxonomy which is both unique and traditional. Here I demonstrate that complex scientific objects exist: objects which generate different systems of scientific classification, produce myriad legitimate alternatives amongst the nonetheless still natural kinds, and make the hierarchical dream impossible to realize, except at absurdly great cost. Philosophical hopes (...) for a certain order in nature cannot be fulfilled. Natural kinds crosscut one another, ubiquitously so, and this crosscutting spells the end of the hierarchical dream. (shrink)

The neo-Kohlbergian approach to moral reasoning development maintains that intermediate concepts lie between bedrock moral schemas and professional codes of ethics and deal with issues of confidentiality, competence, informed consent, allocation of resources and professional autonomy (Rest et. al, 1999b Rest, J., Narvaez, D., Bebeau, M., & Thoma, S. J. (1999b). Postconventional moral thinking: A neo-Kohlbergian approach. Lawrence Erlbaum Associates.[Crossref], [Google Scholar]). Intermediate concepts provide concrete guides for behavior, they contrast general moral schemas that are concerned with issues of fairness, (...) justice and equality. This paper outlines the development and testing of a prototype Intermediate Concept Measure for teachers (TICM). Results indicate that the TICM has respectable psychometric properties and assesses a construct in the moral domain. (shrink)

More than a decade of exacting scientific research involving paleontological fragments and ancient DNA has lately produced a series of pronouncements about a purportedly novel population of archaic hominins dubbed “the Denisova.” The science involved in these matters is both technically stunning and, socially, at times a bit reckless. Here I discuss the responsibilities which scientists incur when they make inductively risky pronouncements about the different relative contributions by Denisovans to genomes of members of apparent subpopulations of current humans. This (...) science is sensational: it is science which empirically speculates, to the public delight’s and entertainment, about scintillating topics such as when humans evolved, where we came from, and who else we were having sex with during our early hominin history. An initial characterization of sensational science emerges from my discussion of the case, as well as a diagnosis of an interactive phenomenon termed amplified inductive risk. (shrink)

Altruism is generally understood to be behavior that benefits others at a personal cost to the behaving individual. However, within evolutionary biology, different authors have interpreted the concept of altruism differently, leading to dissimilar predictions about the evolution of altruistic behavior. Generally, different interpretations diverge on which party receives the benefit from altruism and on how the cost of altruism is assessed. Using a simple trait-group framework, we delineate the assumptions underlying different interpretations and show how they relate to one (...) another. We feel that a thorough examination of the connections between interpretations not only reveals why different authors have arrived at disparate conclusions about altruism, but also illuminates the conditions that are likely to favor the evolution of altruism. (shrink)

This guide to the most interesting work that has recently appeared on Aquinas reflects the revival of interest in his work.

This book defends the view that any adequate account of rational decision making must take a decision maker's beliefs about causal relations into account. The early chapters of the book introduce the non-specialist to the rudiments of expected utility theory. The major technical advance offered by the book is a 'representation theorem' that shows that both causal decision theory and its main rival, Richard Jeffrey's logic of decision, are both instances of a more general conditional decision theory. The book solves (...) a long-standing problem for Jeffrey's theory by showing for the first time how to obtain a unique utility and probability representation for preferences and judgements of comparative likelihood. The book also contains a major new discussion of what it means to suppose that some event occurs or that some proposition is true. The most complete and robust defence of causal decision theory available. (shrink)

Alarmed by the domination inherent in the patriarchal idea of truth, the author sketches principles that allow her to develop accounts of reality-to "do theory"-without implying that others should agree. This epistemological setting supports differences among wimmin that are expressed in different understandings of the world; it also supports agreement.

In his contribution to this volume, Paul Bloomfield analyzes and attempts to answer the question “Why is it bad to be bad?” I too will use this question as my point of departure; in particular I want to approach the matter from the perspective of a moral error theorist. This discussion will preface one of the principal topics of this paper: the relationship between morality and self-interest. Again, my main goal is to clarify what the moral error theorist might say (...) on this subject. Against this background, the final portion of this paper will be a discussion of moral fictionalism, defending it from some objections. (shrink)

Joyce Avrech Berkman interprets Edith Stein’s autobiography as time and space bound, yet arrestingly transgressive. She probes the origins, nature, and afterlife of Stein’s work, which sheds light on Stein’s response to Nazi antisemitism and the roots of her key philosophical and spiritual concerns.

Essence/esse distinction and composition -- The argumentation for real distinction in De ente, cap. 4 -- Essence -- Esse -- The proof of God -- The causal principle -- The Per aliud principle and infinite regress -- Esse tantum -- Creation.

The term ‘predistribution’ draws attention to the need for policies and institutions that are designed to improve the position of the least advantaged members of society by generating a fairer distribution of opportunities and benefits from the operation of the free market system, with less reliance on redistributive tax-and-transfer mechanisms. Although the idea of progressive predistribution has only recently begun to attract the attention of politicians and commentators in the mainstream media, there is an older and more philosophically grounded predistributive (...) approach that goes back to the idea of the property-owning democracy proposed by Economist James Meade and further developed by liberal political philosopher John Rawls. In this article, I argue that neither the Meadeian/Rawlsian POD model, nor the more recent analysis of the idea of progressive predistribution, provide a clear and convincing account of the distinction between predistributive and redistributive mechanisms. I then argue that a more promising account of this distinction is provided by the idea of the socialization of economic rent through taxation of the rental value of land, and that there are good reasons to think that a shift in the burden of taxation away from production and employment and on to the rental value of land might turn out to be both more genuinely predistributive and more effectively progressive than other possible predistributive mechanisms that have recently been proposed, most notably the aggressive taxation of private inheritances as a means to broaden the distribution of privately owned capital and productive property. (shrink)

This is a translation, by A. Létourneau, of a book by Fergus Kerr, Theology after Wittgenstein previously published by Oxford U. Press The author provides a reading of Wittgenstein, and explains how theology as a discipline can take into account his main philosophical thoughts about religion and ethics.

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