This article illustrates the shortcomings of an objectivist epistemology in publicly accounting for technological accidents. Public inquiries convened in the aftermath of accidents tend to operate with such an objectivist approach and, as a result, usually assign blame to either or both of two causal culprits: technical malfunction and socio-organizational failure. Following Downer, I argue that a constructivist understanding of technological failure opens the possibility of a third type of cause—one that is epistemological in nature. Public inquiries frequently fail to (...) recognize these “epistemic accidents” and are thereby limited in their capacity to effect positive change. Using the case of a 2003 railway accident near Sydney, Australia, and the public inquiry that was convened in its wake, this article argues that recognizing the epistemological origins of failure holds promise for a more constructive way of accounting for and learning from technological accidents. (shrink)

Clinical research is a necessity if effective and safe treatments are to be developed. However, this may well include the need for research that is best described as ‘invasive’ in that it may be associated with some discomfort or inconvenience. Limitations in the undertaking of invasive research involving people with intellectual disabilities (ID) are perhaps related to anxieties within the academic community and among ethics committees; however, the consequence of this neglect is that innovative treatments specific to people with ID (...) may not be developed. Such concerns are likely to continue while there is limited published knowledge regarding the actual experiences of people with ID who have participated in invasive clinical research. As part of a pilot study trialling the novel use of a surgically inserted device to curb overeating in people with Prader–Willi syndrome (PWS) we have investigated the experience of research through semistructured qualitative interviews involving three participants and their carers. Thematic analysis revealed that the adults with PWS and their family carers rated their participation positively, seeing it as a rewarding and enriching experience. This brief report discusses findings from our interview data in order to highlight strategies which may ensure that research is acceptable to participants, meets the necessary ethical standards and is able to achieve the aims set out by the researchers. To our knowledge, this is the first study to record experiences directly from people with PWS and their carers regarding their involvement in invasive clinical research. (shrink)

Throughout most of human history women have been defined by their biological role in reproduction, seen first and foremost as gestators, which has led to the reproductive system being subjected to outside interference. The womb was perceived as dangerous and an object which husbands, doctors and the state had a legitimate interest in controlling. In this article, we consider how notions of conflict surrounding the womb have endured over time. We demonstrate how concerns seemingly generated by the invisibility of reproduction (...) and the inaccessibility of the womb have translated into similar arguments for controlling women, as technology increases the accessibility of the female body and the womb. Developments in reproductive medicine, from in vitro fertilisation (IVF) to surrogacy, have enabled women and men who would otherwise have been childless to become parents. Uterus transplants and ‘artificial wombs’ could provide additional alternatives to natural gestation. An era of ‘womb technology’ dawns. Some argue that such technology providing an alternative to ‘natural’ gestation could be a source of liberation for female persons because reproduction will no longer be something necessarily confined to the female body. ‘Womb technology’, however, also has the potential to exacerbate the labelling of the female body as a source of danger and an ‘imperfect’ site of gestation, thus replaying rudimentary and regressive arguments about controlling female behaviour. We argue that pernicious narratives about control, conflict and the womb must be addressed in the face of these technological developments. (shrink)

Papers on nanotechnology in the Scientific Electronic Library Online database were studied bibliometrically. The terms ‘nanotechnology’, ‘nanoparticle’, ‘graphene’, ‘fullerene’, ‘nanotube’ and ‘quantum dot’ were used for the search in their singular and plural forms in three languages, and a total of 1205 papers were selected for the study to assess the frequency rates of the study variables. The results of the study are presented in this article focusing on gender differences.

Although a second-person neuroscience has high ecological validity, the extent to which a second- versus third-person neuroscience approach fundamentally alters neural patterns of activation requires more careful investigation. Nonetheless, we are hopeful that this new avenue will prove fruitful in significantly advancing our understanding of typical and atypical social cognition.

Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision‐making. The boundaries between human‐ and nonhuman‐driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never (...) before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision‐making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

Individuals are more likely to remember emotional than neutral information, but this benefit does not always extend to the surrounding background information. This memory narrowing is theorised to be linked to the availability of attentional resources at encoding. In contrast to the predictions of this theoretical account, altering participants' attentional resources at encoding by dividing attention did not affect emotion-induced memory narrowing. Attention was divided using three separate manipulations: a digit ordering task (Experiment 1), an arithmetic task (Experiment 2) and (...) an auditory discrimination task (Experiment 3). Across all three experiments, divided attention decreased memory across the board but did not affect the degree of memory narrowing. These findings suggest that theories to explain memory narrowing must be expanded to include other potential mechanisms beyond the limitations of attentional resources. (shrink)

This paper describes a presentation on ethics for accounting and business students. In 2001 and 2002, major corporate failures such as Enron and Worldcom, combined with questionable accounting practices, made ethics a paramount concern to persons working in business and accounting. While financial statement analysis and regulatory requirements are important technical topics, the issue of ethics provides faculty a unique and very appropriate setting to discuss deeper truths about doing business and living life well. This paper briefly describes the development (...) and assessment of one approach to presenting ethics built around a computerized slide show (PowerPoint). The goal of the presentation is to increase students’ understanding of the essential role of ethics to accounting and business. Following the presentation, students indicated a heightened recognition of the importance of ethics. Educators should do all that they can to encourage students to do the “right” thing, even in difficult circumstances. This encouragement may serve them well in school and later in their careers. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

In recognition memory paradigms, emotional details are often recognised better than neutral ones, but at the cost of memory for peripheral details. We previously provided evidence that, when periph...

The Coronavirus Disease 2019 pandemic prompted the need for a teleneuropsychology protocol for the cognitive assessment of older adults, who are at increased risk for both COVID-19 and dementia. Prior recommendations for teleneuropsychological assessment did not consider many of the unique challenges posed by COVID-19. The field is still in need of clear guidelines and standards of care for the assessment of older adults under the current circumstances. Advantages of teleneuropsychological assessment during the COVID-19 pandemic include reduced risk of contracting (...) the virus, eliminating travel time and reducing cost, and more rapid access to needed services. Challenges include disparities in technology access among patients, reduced control over the testing environment, impeded ability to make behavioral observations, and limited research on valid and reliable cognitive assessment measures. The aim of this perspective review is to propose a teleneuropsychological protocol to facilitate neuropsychological assessment utilizing a virtual platform. The proposed protocol has been successful with our clinical and research populations and may help neuropsychologists implement teleneuropsychology services without compromising validity or reliability. However, there is increasing need for research on teleneuropsychological assessment options for both clinical and research purposes. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

This paper explores the concept of “gendered seeing”: the capacity to visually perceive another person's gender and the role that one's own gender plays in that perception. Assuming that gendered properties are actually perceptible, my goal is to provide some support from the philosophy of perception on how gendered visual experiences are possible. I begin by exploring the ways in which sociologists and psychologists study how we perceive one's sex and the implications of these studies for the sex/gender distinction. I (...) then discuss feminist philosopher Linda Alcoff's concept of “interpretative horizons,” which highlights the role that one's social and political identities play in how we understand the world around us. I also discuss Elizabeth Grosz's notion of double sensation. I then apply some work in the philosophy of perception on perceptual learning and the cognitive penetration of perception to gendered seeing. My hypothesis is that we can explain how one's interpretative horizons are acquired through some notion of perceptual learning. I conclude by suggesting some of the epistemic and ethical implications of gendered seeing. (shrink)

Recent arguments claim that behavioral science has focused – to its detriment – on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, “positive deviants,” and the system limitations they navigate, we offer potentially greater policy solutions.

The essays in Object-Oriented Feminism explore OOF: a feminist intervention into recent philosophical discourses--like speculative realism, object-oriented ontology (OOO), and new materialism--that take objects, things, stuff, and matter as primary. Object-oriented feminism approaches all objects from the inside-out position of being an object too, with all of its accompanying political and ethical potentials. This volume places OOF thought in a long history of ongoing feminist work in multiple disciplines. In particular, object-oriented feminism foregrounds three significant aspects of feminist thinking in (...) the philosophy of things: politics, engaging with histories of treating certain humans (women, people of color, and the poor) as objects; erotics, employing humor to foment unseemly entanglements between things; and ethics, refusing to make grand philosophical truth claims, instead staking a modest ethical position that arrives at being "in the right" by being "wrong." Seeking not to define object-oriented feminism but rather to enact it, the volume is interdisciplinary in approach, with contributors from a variety of fields, including sociology, anthropology, English, art, and philosophy. Topics are frequently provocative, engaging a wide range of theorists from Heidegger and Levinas to Irigaray and Haraway, and an intriguing diverse array of objects, including the female body as fetish object in Lolita subculture; birds made queer by endocrine disruptors; and truth claims arising in material relations in indigenous fiction and film. Intentionally, each essay can be seen as an "object" in relation to others in this collection. Contributors: Irina Aristarkhova, University of Michigan; Karen Gregory, University of Edinburgh; Marina Gržinic, Slovenian Academy of Science and Arts; Frenchy Lunning, Minneapolis College of Art and Design; Timothy Morton, Rice University; Anne Pollock, Georgia Tech; Elizabeth A. Povinelli, Columbia University; R. Joshua Scannell, CUNY Graduate Center; Adam Zaretsky, VASTAL. (shrink)

When are we obligated to believe someone? To what extent are people authorities about their own experiences? What kind of harm might we enact when we doubt? Questions like these lie at the heart of many debates in social and feminist epistemology, and they’re the driving issue behind a key conceptual framework in these debates—gaslighting. But while the concept of gaslighting has provided fruitful insight, it's also proven somewhat difficult to adjudicate, and seems prone to over-application. In what follows, I (...) argue that Katherine Hawley's theory of trust can provide a useful alternative lens for looking at contested testimony. To do this, I focus on a particularly complex—but increasingly popular—application of gaslighting: the physician/patient relationship, and the idea of ‘medical gaslighting’. I argue that, even though patients can experience harm when they are disbelieved, there are nevertheless good reasons for physicians not to trust patients about at least some of their own narratives. (shrink)

This is an important volume of seventeen essays that historicizes observation as a practice, concept and ideal. It belongs to the historiographical tradition of scrutinizing central aspects of the scientific enterprise such as experiments and objectivity that once appeared too self-evident to be probed. The challenge of historicizing such a significant idea is that it has to be a collective enterprise.The volume starts with three essays that provide a chronological survey of the period from 500 to 1800. Katherine Park, (...) covering the period from 500 to 1500, explains how observation for Cicero and Pliny had nothing to do with experiment or systematic investigation, but rather was a collective and largely anonymous process, associated with originary phrases of natural knowledge of a distant past and intelligible even by the illiterate. It was the basis for conjectural knowledge that lacked causal explanation. Observation of celestial events occurred from time to time, but in the context o .. (shrink)

In this paper, I argue that there is a notion of 'counterfactual success' which stands to knowledge how as true belief stands to propositional knowledge. (I attempt to avoid the question of whether knowledge how is a type of propositional knowledge.).

In 2017, a Philadelphia research team revealed the closest thing to an artificial womb the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology, that might change these (...) odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the ‘human being growing in the AW’ being described with inherently value laden terminology. The ‘human being in an AW’ is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term ‘gestateling’ should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration. (shrink)

The inhuman in the humanities : Darwin and the ends of man -- Deleuze, Bergson, and the concept of life -- Bergson, Deleuze, and difference -- Feminism, materialism, and freedom -- The future of feminist theory : dreams for new knowledges -- Differences disturbing identity : Deleuze and feminism -- Irigaray and the ontology of sexual difference -- Darwin and the split between natural and sexual selection -- Sexual difference as sexual selection : Irigarayan reflections on Darwin -- Art and (...) the animal -- Living art and the art of life : women's painting from the western desert. (shrink)

This is a short response to Aaron Cotnoir's 'Composition as General Identity', in which I suggest some further applications of his ideas, and try to press the question of why we should think of his 'general identity relation' as a genuine identity relation.

In ‘Ethics of sharing medical knowledge with the community: is the physician responsible for medical outreach during a pandemic?’ Strous and Karni note that the revised physician’s pledge in the World Medical Association Declaration of Geneva obligates individual physicians to share medical knowledge, which they interpret to mean a requirement to share knowledge publicly and through outreach. In the context of the COVID-19 pandemic, Strous and Karni defend a form of medical paternalism insofar as the individual physician must reach out (...) to communities who may not want, or know to seek out, medical advice, for reasons of public health and health equity. Strous and Karni offer a novel defence of why physicians ought to intervene even in insular communities, and they offer suggestions for how this could be done in culturally sensitive ways. Yet their view rests on an unfounded interpretation of the Geneva Declaration language. More problematically, their paper confuses shared and collective responsibility, misattributing the scope of individual physician obligations in potentially harmful ways. In response, this reply delineates between shared and collective responsibility, and suggests that to defend the obligation of medical outreach Strous and Karni propose, it is better conceptualised as a collective responsibility of the medical profession, rather than a shared responsibility of individual physicians. This interpretation rejects paternalism on the part of individual providers in favour of a more sensitive and collaborative practice of knowledge sharing between physicians and communities, and in the service of collective responsibility. (shrink)

Narrative is now a commonly used term in medical education, ethics, and practice. Yet the concept of narrative defies singular definition, and definitional and functional pluralism about narrative in health care remains underappreciated. Diverse conceptualizations of narrative are generically grouped under umbrella terms like “medical humanities” or “narrative medicine.” Such broad grouping risks undermining attention to relevant differences in use, meaning, or theory of narrative, overestimating the scope of certain criticisms of narrative practice or use, while overlooking more insidious concerns. (...) This essay moves toward a conceptual clarification of narrative in medicine through a process of naming and sorting. Narrative conceptualizations are grouped into narrative premises which include descriptive and normative claims about narrative, and narrative practices, which put narrative into action as process, method, or tool. A philosophical pragmatist approach to narrative in medicine reworks narrative anxieties about fact and fiction, truth or falsehood, in terms of the justifiability of belief, the inclusion or exclusion of experience, and the rationality of practices that are never perfect and always up for revision. (shrink)

Conspiracy theorists believe that powerful agents are conspiring to achieve their nefarious aims and also to orchestrate a cover-up. People who suffer from impostor syndrome believe that they are not talented enough for the professional positions they find themselves in, and that they risk being revealed as inadequate. These are quite different outlooks on reality, and there is no reason to think that they are mutually reinforcing. Nevertheless, there are intriguing parallels between the patterns of trust and distrust which underpin (...) both conspiracy theorising and impostor thinking. In both cases subjects distrust standard sources of information, instead regarding themselves as especially insightful into the underlying facts of the matter. In both cases, seemingly-anomalous data takes on special significance. And in both cases, the content of belief dictates the epistemic behaviour of the believer. This paper explores these parallels, to suggest new avenues of research into both conspiracy theorising and impostor syndrome, including questions about whether impostor syndrome inevitably involves a personal failure of rationality, and issues about how, if at all, it is possible to convince others to abandon either conspiracy theories or impostor attitudes. (shrink)

This chapter will focus on the biomedical moral enhancement of offenders – the idea that we could modify offenders’ brains in order to reduce the likelihood that they would engage in immoral, criminal behaviour. Discussions of the permissibility of using biomedical means to address criminal behaviour typically analyse the issues from the perspective of medical ethics, rather than penal theory. However, recently certain theorists have discussed whether brain interventions could be legitimately used for punitive (as opposed to purely therapeutic) purposes. (...) For instance, Jesper Ryberg argues (although he himself is not a retributivist) that there is nothing to prevent retributivists from endorsing brain interventions as a legitimate form of retributive punishment. Legal academics have not yet paid sufficient attention to whether this proposal would be compatible with international human rights law, nor have retributivist philosophers discussed whether their favoured penal theories have the conceptual resources to explain why brain interventions would not be an appropriate method of punishment. This chapter considers whether there is any indication that these interventions are being used at present for punitive purposes and whether this would violate the European Convention on Human Rights. It examines different versions of retributivism and considers which theory is in the best position to challenge the use of brain interventions as a form of punishment. Finally, it considers whether offering these interventions as an alternative to punishment would violate principles of proportionality. (shrink)

On Hume's account, when we lack virtues that would typically prompt moral action, we can instead be motivated by the "sense of duty." Surprisingly, Hume seems to maintain that, in such cases, we are motivated by a desire to avoid the unpleasantness of "self-hatred" evoked in us when we realize we lack certain traits others possess. This account has led commentators to argue that Hume is not a moral internalist, since motivation by duty is motivation by a self-interested desire. This (...) paper concludes that Hume is indeed a moral internalist and that the motive of duty can be understood as a form of motivation by moral disapprobation in a way supported by Hume's general motivational psychology. (shrink)

There is an emerging ethical consensus that injured research participants should receive medical care and compensation for their research-related injuries. This consensus is premised on notions of beneficence, distributive justice, compensatory justice and reciprocity. In response, countries around the world have implemented no-fault compensation systems to ensure that research participants are adequately protected in the event of injury. The United States, the world's leading sponsor of research, has chosen instead to rely on its legal system to provide injured research participants (...) with medical care and compensation. This article argues that US reliance on its legal system leaves injured research participants unprotected in the event of injury. Nearly every injured research participant will have difficulty receiving compensation in court, and certain classes of research participants will be barred from receiving compensation altogether. The United States’ outlier status also threatens to impede US-sponsored multinational research, potentially delaying important biomedical advances. To rectify this injustice, researchers, Institutional Review Boards, sponsors and research institutions should advocate systematic no-fault compensation in the United States to bring US law into accord with global ethical norms and ensure that injured research participants are adequately protected. (shrink)

Energy has an ambivalent status in social theory, variously figuring as a driver or an outcome of social and institutional change, or as something that is woven into the fabric of society itself. In this article the authors consider the underlying models on which different approaches depend. One common strategy is to view energy as a resource base, the management and organization of which depends on various intersecting systems: political, economic and technological. This is not the only route to take. (...) The authors develop an alternative approach, viewing energy supply and energy demand as part of the ongoing reproduction of bundles and complexes of social practice. In articulating and comparing these two positions they show how social-theoretical commitments influence the ways in which problems like those of reducing carbon emissions are framed and addressed. Whereas theories of practice highlight basic questions about what energy is for, these issues are routinely and perhaps necessarily obscured by those who see energy as an abstract resource that structures or that is structured by a range of interlocking social systems. (shrink)