Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing and (...) services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A (...) smaller majority reported changes in personality specifically. Some expressed reservations about the scientific status of the term ‘personality,’ while others used it freely. Most researchers discussed negative PMB changes, but a majority said that DBS/aDBS can also result in positive changes. Several researchers viewed positive PMB changes as part of the therapeutic goal in psychiatric applications of DBS/aDBS. Finally, several discussed potential causes of PMB changes other than the device itself. (shrink)

While the value of early detection of dementia is largely agreed upon, population-based screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled “case-finding” or “detection of cognitive impairment”. Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions (...) and delimitations of the concepts (the _what_ of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the _how_ of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population-based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished. (shrink)

The proliferation of multistakeholder initiatives (MSIs) over the past years has sparked an intense debate on the political role of corporations in the governance of global business conduct. To gain a better understanding of corporate political behavior in multistakeholder governance, this article investigates how firms construct a political identity when participating in MSIs. Based on an in-depth case study of the Accord on Fire and Building Safety in Bangladesh—an MSI established after the collapse of the Rana Plaza garment factory complex (...) in 2013 to improve working conditions in the Bangladeshi garment industry—we introduce the construct of a political CSR (corporate social responsibility) identity (PCSRI) and explore how firms construct their PCSRIs in MSIs. Employing a qualitative, inductive theory-building method, we analyze interviews and archival data to develop a framework that elucidates how companies construct their PCSRIs within a continuum ranging from conservative to progressive. We show that constructing a PCSRI involves enacting specific, yet interrelated, political strategies that are themselves shaped by several forces over time. This article contributes to the literature by providing a political perspective on organizational identity construction that extends the emerging integrative perspective in political corporate social responsibility (PCSR) research. We suggest that MSIs should be conceptualized as inherently political governance mechanisms that are driven by multidirectional and dynamic political processes of identity construction. Our study shows that corporate political engagement in MSIs is a more nuanced and complex phenomenon than presently theorized. (shrink)

Recent efforts in a range of scientific fields have emphasised research and methods concerning individual differences and individualisation. This article brings together various scientific disciplines—ecology, evolution, and animal behaviour; medicine and psychiatry; public health and sport/exercise science; sociology; psychology; economics and management science—and presents their research on individualisation. We then clarify the concept of individualisation as it appears in the disciplinary casework by distinguishing three kinds of individualisation studied in and across these disciplines: Individualisation ONE as creating/changing individual differences (the (...) process that generates differences between individuals: intrapopulation or intraspecific variation/heterogeneity); Individualisation TWO as individualising applications (the tailoring or customising of something—information, treatment, a product or service, etc.—for an individual or specific group of individuals); and Individualisation THREE as social changes influencing autonomy, risk, and responsibilities (the process discussed under the rubric of sociological individualisation theory). Moreover, we analyse conceptual links between individualisation and individuality, and characterise different sorts of individuality that the disciplines study. This paper aims to promote interdisciplinary research concerning individualisation by establishing a common conceptual-theoretical basis, while leaving room for disciplinary differences. (shrink)

The COVID-19 pandemic has been devastating for people living with dementia (PLWD) and their caregivers. While prior research has documented these effects, it has not delved into their specific causes or how they are modified by contextual variation in caregiving circumstances.

Artificial Intelligence (AI) has the potential to influence people’s lives in various ways as it is increasingly integrated into important decision-making processes in key areas of society. While AI offers opportunities, it is also associated with risks. These risks have sparked debates about how AI should be regulated, whether through government regulation or industry self-regulation. AI-related risk perceptions can be shaped by national cultures, especially the cultural dimension of uncertainty avoidance. This raises the question of whether people in countries with (...) higher levels of uncertainty avoidance might have different preferences regarding AI regulation than those with lower levels of uncertainty avoidance. Therefore, using Hofstede’s uncertainty avoidance scale and data from ten European countries (N = 7.855), this study investigates the relationships between uncertainty avoidance, people’s AI risk perceptions, and their regulatory preferences. The findings show that people in countries with higher levels of uncertainty avoidance are more likely to perceive AI risks in terms of a lack of accountability and responsibility. While people’s perceived AI risk of a lack of accountability exclusively drives their preferences for government regulation of AI, the perceived AI risk of a lack of responsibility can foster people’s requests for government regulation and/or industry self-regulation. This study contributes to a better understanding of which mechanisms shape people’s preferences for AI regulation. (shrink)

Journal of Social Philosophy, EarlyView.

History has demonstrated the necessity of protecting research participants. Research ethics are based on a concept of asymmetry of power, viewing the researcher as powerful and potentially dangerous and establishing ethics committees as external agencies in the field of research. We argue in favour of expanding this perspective on relationships of power to encompass the ethics committees as one among several actors that exert power and that act in a relational interplay with researchers and participants. We employ Michel Foucault’s ideas (...) of power as an omnipresent force which is dynamic and unstable, as well as the notion that knowledge and power are inextricably intertwined. The article discusses how research ethics committees may affect academic freedom. In addition it is pointed out that research participants could be harmed — not only by unfortunate research practices, but also by being subjected to the protective efforts of ethics monitoring bodies. (shrink)

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care (...) left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. (shrink)

"Is it meaningful to call oneself a democrat? And if so, how do you interpret the word?" -/- In responding to this question, eight iconoclastic thinkers prove the rich potential of democracy, along with its critical weaknesses, and reconceive the practice to accommodate new political and cultural realities. Giorgio Agamben traces the tense history of constitutions and their coexistence with various governments. Alain Badiou contrasts current democratic practice with democratic communism. Daniel Bensaid ponders the institutionalization of democracy, while Wendy Brown (...) discusses the democratization of society under neoliberalism. Jean-Luc Nancy measures the difference between democracy as a form of rule and as a human end, and Jacques Rancière highlights its egalitarian nature. Kristin Ross identifies hierarchical relationships within democratic practice, and Slavoj Zizek complicates the distinction between those who desire to own the state and those who wish to do without it. -/- Concentrating on the classical roots of democracy and its changing meaning over time and within different contexts, these essays uniquely defend what is left of the left-wing tradition after the fall of Soviet communism. They confront disincentives to active democratic participation that have caused voter turnout to decline in western countries, and they address electoral indifference by invoking and reviving the tradition of citizen involvement. Passionately written and theoretically rich, this collection speaks to all facets of modern political and democratic debate. (shrink)

Empowerment and user participation represents an ideal of power with a strong position in the health sector. In this article we use text analysis to investigate notions of power in a program plan for health workers focusing on empowerment. Issues addressed include: How are relationships of power between users and helpers described in the program plan? Which notions of user participation are embedded in the plan? The analysis is based on Foucault’s idea that power which is made subject to attempts (...) of redistribution will re-emerge in other forms. How this happens, and with what consequences, is our analytical concern. The analysis is contrasted with ‘snapshots’ from everyday life in a nursing home. The program plan communicates empowerment as a democracy-building instrument that the users need. It is a tool for providing expert assistance to the user’s self-help. User participation is made into a tool which is external to the user him-/herself. Furthermore, the analysis shows that the plan’s image of empowerment presupposes an ‘élite user’ able to articulate personal needs and desires. This is not very applicable to the most vulnerable user groups, who thereby may end up in an even weaker position. By way of conclusion, we argue that an exchange of undesirable dominating paternalism for a desirable empowerment will not abolish power, but may result in more covert and subtle forms of power that are less open to criticism. The paper offers insights that will facilitate reflections on the premises for practising empowerment-oriented health care. (shrink)

Alternative food networks, such as farmers’ markets and community-supported agricultural and fishery programs, often struggle to reach beyond a consumer base that is predominantly white and affluent. This case study explores seven inclusion strategies deployed by a community-supported fishery program (Fishadelphia, in Philadelphia, PA, USA) including discounting prices, accepting payment in multiple forms and schedules, offering a range of product types, communicating and recruiting through a variety of media (especially in person), and choosing local institutions and people of color (POC) (...) as pickup location hosts. Our analysis indicated that all of these strategies were associated with increased participation of customers of color and/or customers without a college degree. For Asian customers, accepting cash, offering whole fish, recruiting in-person, and POC-hosted pickup locations were key factors. For Black customers, discounted price, accepting cash, offering fillets, and communicating through means other than email were most important. Discounted price and communicating through means other than email were most important for customers without a college degree. Payment method, payment schedule and communication method were highly correlated with other strategies; we suggest that these strategies work in synergy to make the program attractive and feasible to these customers. We consider how Fishadelphia’s inclusion efforts have benefitted from both tactical approaches (i.e., programmatic features) and a structural approaches (i.e., the people and places represented within the project), and suggest that elements of both tactical and structural inclusion can be applied in other contexts. This work is crucial for increasing food access, and underscores the importance of relationships in recruiting diverse customers. (shrink)

The expansion of research on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises important neuroethics and policy questions related to data sharing. However, there has been little empirical research on the perspectives of experts developing these technologies. We conducted semi-structured, open-ended interviews with aDBS researchers regarding their data sharing practices and their perspectives on ethical and policy issues related to sharing. Researchers expressed support for and a commitment to sharing, with most saying that they were either sharing their data (...) or would share in the future and that doing so was important for advancing the field. However, those who are sharing reported a variety of sharing partners, suggesting heterogeneity in sharing practices and lack of the broad sharing that would reflect principles of open science. Researchers described several concerns and barriers related to sharing, including privacy and confidentiality, the usability of shared data by others, ownership and control of data (including potential commercialization), and limited resources for sharing. They also suggested potential solutions to these challenges, including additional safeguards to address privacy issues, standardization and transparency in analysis to address issues of data usability, professional norms and heightened cooperation to address issues of ownership and control, and streamlining of data transmission to address resource limitations. Researchers also offered a range of views on the sensitivity of neural activity data (NAD) and data related to mental health in the context of sharing. These findings are an important input to deliberations by researchers, policymakers, neuroethicists, and other stakeholders as they navigate ethics and policy questions related to aDBS research. (shrink)

It’s common to think that animals think. The cat thinks it is time to be fed, the monkey thinks the dominant is a threat. In order to make sense of what the other animals around us do, we ascribe mental states to them. The cat meows at the door because she wants to be let in. The monkey the monkey fails the test because he doesn’t remember the answer. -/- We explain animal actions in terms of their mental states, just (...) as we do with humans. One of us has argued that our science of animal minds requires that animal behavior be explained in such terms, and this doesn’t lead to a problematic use of folk psychology or anthropomorphism (Andrews 2016, 2020). By “anthropomorphism” we mean the attribution of human psychological, social, or normative properties to non-human animals “usually with the implication it is done without sound justification” (Shettleworth 2010, 477). And by “folk psychology” we mean the commonsense practice of seeing action as caused or accompanied by mental states like belief and desire, emotions, and seeing people in terms of their moods or personality traits, as well as categorizing complex behaviors as examples of grieving, communicating, or teaching (Andrews 2012). Psychologists routinely describe human behaviors in folk psychological terms, so it’s not that the categories are unscientific. The issue with using folk psychology to describe animal behavior is whether observable similarities between human and nonhuman behavior warrants thinking they involve the same psychological kind. The use of folk psychology when talking about animals need not be problematically anthropomorphic, though we need some evidentiary basis for filing animal behavior under some folk psychological category. -/- Despite it being commonplace for humans to attribute thoughts to animals, and there being arguments in favor of doing so in science, the nature of these mental states so many are happy to see in other animals remains unclear. To help bring some focus into the discussion, we will examine the attitude of belief. In this chapter we will examine the various possible statuses of animal beliefs, and the implications of those various views for our folk practice as well as our scientific investigations. (shrink)

The application of machine learning in health care holds great promise for improving care. Indeed, our own team is collaborating with experts in machine learning and statistical modeling to bu...

Traditionally, discussions of moral participation – and in particular moral agency – have focused on fully formed human actors. There has been some interest in the development of morality in humans, as well as interest in cultural differences when it comes to moral practices, commitments, and actions. However, until relatively recently, there has been little focus on the possibility that nonhuman animals have any role to play in morality, save being the objects of moral concern. Moreover, when nonhuman cases are (...) considered as evidence of moral agency or subjecthood, there has been an anthropocentric tendency to focus on those behaviors that inform our attributions of moral agency to humans. For example, some argue that the ability to evaluate the principles upon which a moral norm is grounded is required for full moral agency. Certainly, if a moral agent must understand what makes an action right or wrong, then most nonhuman animals would not qualify (and perhaps some humans too). However, if we are to understand the evolution of moral psychology and moral practice, we need to turn our attention to the foundations of full moral agency. We must first pay attention to the more broadly normative practices of other animals. Here, we begin that project by considering evidence that great apes and cetaceans participate in normative practices. (shrink)

In their article “Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?” Bayefsky and Berkman briefly mention that: “[s]ome are...

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

Background: International developments suggest that providing clinical ethics services to help clinicians negotiate ethical issues that arise in clinical practice is beneficial and reflects best practice in promoting high ethical standards and patient-centered care. The aim of this study was to explore the needs and experiences of clinical staff members to inform the development of future clinical ethics support. Methods: Health professionals at a large regional health service completed an online survey containing questions about the frequency of ethical and legal (...) issues encountered in clinical practice, the type of situations that gave rise to the ethical and/or legal uncertainty or concern, how clinicians currently address these issues, and what support would be welcome. Results: The survey was completed by 369 staff members, including 61% with more than 10 years in the profession and 51% in nursing/midwifery. Two-thirds (66%) indicated they often considered ethical implications of their clinical decisions, and half (49%) often considered the legal implications. More than half (58%) were often/occasionally concerned about the ethically right thing to do. Patient requests for borderline treatment (47%), staff disagreements about patient care (48%), and patients declining recommended treatment (54%) were the most frequent reasons given for ethical or legal uncertainty. Sixty-nine percent of respondents indicated that the way their department addressed ethical issues could be improved and 85% agreed that there is a need for more discussion on ethical issues. The majority (82%) of respondents had encountered ethically challenging clinical situations where additional support would have helped. Common approaches to issues were discussion with colleagues/supervisor (91.1%), discussion at handover/group forums (50.8%), and consultation with guidelines/protocols (60.9%). Conclusions: A majority of clinical staff members surveyed have encountered ethically/legally challenging cases daily for which they have often sought additional advice. This study indicates that many clinical staff members would welcome some form of additional clinical ethics support including advice and education. (shrink)

Frameworks for responsible data stewardship, such as that proposed by McCoy et al. (2023), are intended to encourage and provide guidelines for data processors to engage in responsible data process...

Much experimental evidence shows that minimally counterintuitive concepts, which violate one intuitive ontological expectation of domain-specific natural kinds, are remembered as well as or better than intuitive concepts with no violations of ontological expectations, and much better than maximally counterintuitive concepts with more than one violation of ontological violations. It is also well established that concepts rated as high in imagery, are recalled better than concepts that are low in imagery. We conducted three studies to test whether imagery levels affected (...) recall rates of intuitive, minimally counterintuitive, and maximally counterintuitive concepts. In study 1, we obtained imagery level ratings for 48 three-word items. In study 2, we used the ratings obtained in study 1 in a 2 × 3 recall task in which imagery was manipulated along with counterintutiveness. High imagery items were recalled significantly better than low imagery items for intuitive and maximally counterintuitive items but not for minimally counterintuitive items. Study 3, replicated the findings from study 2 in a 2 × 2 study using a larger number of intuitive and minimally counterintuitive items. In both studies, High imagery items were recalled significantly better than low imagery items for intuitive but not for minimally counterintuitive items. Thus, minimally counterintuitive concepts appear insulated from imagery effects on recall. (shrink)

Agricultural diversification in the Midwestern Corn Belt has the potential to improve socioeconomic and environmental outcomes by buffering farmers from environmental and economic shocks and improving soil, water, and air quality. However, complex barriers related to agricultural markets, individual behavior, social norms, and government policy constrain diversification in this region. This study examines farmer perspectives regarding the challenges and opportunities for both corn and soybean production and agricultural diversification strategies. We analyze data from 20 focus groups with 100 participants conducted (...) in Indiana, Illinois, and Iowa through a combined inductive and deductive approach, drawing upon interpretive grounded theory. Our results suggest that when identifying challenges and opportunities, participants center economics and market considerations, particularly income, productivity, and market access. These themes are emphasized both as benefits of the current corn-soybean system, as well as challenges for diversification. Additionally, logistical, resource and behavioral hurdles– including the comparative difficulty and time required to diversify, and constraints in accessing land, labor, and technical support– are emphasized by participants as key barriers to diversification. Agricultural policies shape these challenges, enhancing the comparative advantage and decreasing the risk of producing corn and soybeans as compared to diversified products. Meanwhile, alternative marketing arrangements, farmer networks, family relationships, and improved soil health are highlighted as important opportunities for diversification. We contextualize our findings within the theories of reasoned action and diffusion of innovation, and explore their implications for farmer engagement, markets, and agricultural policy, and the development of additional resources for business and technical support. (shrink)