Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

The word yoginī is an ambivalent term, generally defined as a female yogin. For the purposes of the University of Hawai′i′s Center for South Asian Studies’ Symposium on the Ineffable in Religion and Ritual, I envisioned the ambivalence of the yoginī as characterized by semantic ineffability. This ineffability is seen in the divergence of definitions and descriptions of the yoginī in text and ethnography. The tantras portray her as flying, blood thirsty, and the object of tantric sex rites; she is (...) rarely portrayed as a yoga practitioner. Human yoginīs in India, by in contrast, often identify themselves as sannyāsinī (renunciate), practice some form of yoga, and are often celibate. To address the question of why textual and human yoginīs bear little in common, I render a polythetic definition of the yoginī by first looking at the many modes of definition and classification used to render meaning of the concepts that are integral to the formation of the yoginī. I then problematize the categorical construction of the yoginī and the disjunction between textual references to the yoginī in tantras of the Vidyāpīṭha (“Wisdom Mantra Corpus” or “Seat of Wisdom”), the Śaiva and Śākta Purāṇas, and ethnographic accounts of embodied yoginīs. These three sources, which emerge from various sectarian, historical, and social milieus offer interrelated yet distinct descriptions of the yoginī and as such provide a broad base of signification upon which to render a polythetic definition. (shrink)

In qualitative interviews with a diverse group of experts, the vast majority believed unregulated researchers should seek out independent oversight. Reasons included the need for objectivity, protecting app users from research risks, and consistency in standards for the ethical conduct of research. Concerns included burdening minimal risk research and limitations in current systems of oversight. Literature and analysis supports the use of IRBs even when not required by regulations, and the need for evidence-based improvements in IRB processes.

The informed consent process for genetic testing does not commonly address preferences regarding disclosure of results in the event of the patient's death. Adults being tested for familial colorectal cancer were asked whether they want their exome sequencing results disclosed to another person in the event of their death prior to receiving the results. Of 78 participants, 92% designated an individual and 8% declined to. Further research will help refine practices for informed consent.

Data documenting poor understanding among research participants and real-time efforts to assess comprehension in large-scale studies are focusing new attention on informed consent comprehension. Within the context of biobanking consent, we previously convened a multidisciplinary panel to reach consensus about what information must be understood for a prospective participant’s consent to be considered valid. Subsequently, we presented them with data from another study showing that many U.S. adults would fail to comprehend the information the panel had deemed essential. When asked (...) to evaluate the importance of the information again, panelists’ opinions shifted dramatically in the direction of requiring that less information be understood. Follow-up interviews indicated significant uncertainty about defining a threshold of understanding and what should happen when prospective participants are unable to grasp key information. These findings have important implications for urgently needed discussion of whether... (shrink)

Ecological restoration and native landscaping are increasing, particularly in the American Midwest, where they form part of the area's history and culture of conservation. But practitioners rarely pause to ask philosophical questions related to categories of native and invasive or human control and harmony with nature. This article brings philosophy into conversation with practice, using members of Wild Ones Native Landscaping, a non-profit headquartered in Neenah, WI, as a case study. Philosophers and ethicists who are studying Ecological Restoration and Native (...) Landscaping can learn valuable lessons – in practicality, aesthetics and flexibility – from practitioners such as the Wild Ones. (shrink)

Climate engineering is subject to the “playing God” critique, which charges that humans should not undertake to control nature in ways that seem to overstep the proper scope of human agency. This argument is easily discredited, and in fact the opposite—that we should “play God”—may be equally valid in some circumstances. To revive the playing God critique, I argue that it functions not on a logical but on a symbolic and emotional level to highlight nostalgia for functional dualisms in the (...) face of the bewildering problem of climate change. It also raises significant questions about the virtue of those who might engineer the climate. These two concerns point to questions about the proper role of human agency. I use the scholarship of Aldo Leopold and H. Richard Niebuhr to argue for a model of human agency based on contextual awareness and responsive, communal responsibility. I conclude with some implications of this view for decision-makers engaging the topic of climate engineering. (shrink)

Science is revolutionizing human reproduction. New techniques are already with us, such as artificial insemination, the freezing of sperm, in vitro fertilization and the use of surrogate mothers. Artificial wombs are clearly on the horizon.

We investigated how two cues to contrast—beat gesture and contrastive pitch accenting—affect comprehenders' cognitive load during processing of spoken referring expressions. In two visual‐world experiments, we orthogonally manipulated the presence of these cues and their felicity, or fit, with the local (sentence‐level) referential context in critical referring expressions while comprehenders' task‐evoked pupillary responses (TEPRs) were examined. In Experiment 1, beat gesture and contrastive accenting always matched the referential context of filler referring expressions and were therefore relatively felicitous on the global (...) (experiment) level, whereas in Experiment 2, beat gesture and contrastive accenting never fit the referential context of filler referring expressions and were therefore infelicitous on the global level. The results revealed that both beat gesture and contrastive accenting increased comprehenders' cognitive load. For beat gesture, this increase in cognitive load was driven by both local and global infelicity. For contrastive accenting, this increase in cognitive load was unaffected when cues were globally felicitous but exacerbated when cues were globally infelicitous. Together, these results suggest that comprehenders' cognitive resources are taxed by processing infelicitous use of beat gesture and contrastive accenting to convey contrast on both the local and global levels. (shrink)

Consumption--the flow of physical materials in human lives--is an important ethical issue. Be it fair trade coffee or foreign oil, North Americans' consumption choices affect the well-being of humans around the globe, in addition to impacting the natural world and consumers themselves. In this book, Laura Hartman seeks to formulate a coherent Christian ethic of consumption.

This book provides ready to use strategies to promote student engagement in online spaces using a variety of tools and strategies to promote student success and retention.

We describe a new approach for developing and validating cognitive process models. We develop graphical models (specifically, hidden Markov models) both from human empirical data on a task, as well as from synthetic data traces generated by a cognitive process model of human behavior on the task. We show that considering differences between the two graphical models can unveil substantive and nuanced imperfections of cognitive process models that can then be addressed to increase their fidelity to empirical data.

GraphicalThe need to encourage individuals as active change agents for sustainability transitions has led researchers across disciplines to conceptualize over 70 constructs to assess relevant dispositions to environmental protection and green consumption behaviors. The generated knowledge is, however, fragmented by an unconsolidated set of constructs developed within parallel literature streams. We, hence, use an integrative review method to capture conceptual and operational similarities and distinctiveness of constructs across disciplines in the literature, attempting to unify the knowledge base. Thereby, we identify (...) 34 conceptually distinct constructs relevant for the thematic synthesis on individual-level constructs framing contributions to environmental measures and issues. We followingly propose a taxonomy, systemizing constructs based on their concept type and contextual scope of the environmental challenge addressed. We capture these dimensions in critically assessing relevant and salient conceptual and operational features. We thus create a consolidated picture of extant constructs capturing individual-level environmental sustainability by which we intend a three-fold contribution to the interdisciplinary field. First, the taxonomy and guiding framework for the choice of constructs should assist substantive researchers in identifying appropriate constructs of interest. Second, the systematic integration of similar concepts available in parallel literature streams should assist future endeavors aiming at integrating substantive findings with regard to antecedents, consequences, and other relevant variables. Finally, the taxonomy revealed that conceptualizations mainly scatter around specific combinations of types and scopes while others remain unaddressed. Based on our critical assessment of the relevant features and resulting taxonomy, we identify avenues for future research dedicated to enhancing conceptual rigor and measurement quality in the field and introducing concepts addressing missing but potentially valuable combinations of types and scopes. We conclude that researchers engaging in the proposed avenues with conceptual, methodological, or empirical contributions should consider four critical aspects to advance knowledge accumulation and prevent fragmentation in the interdisciplinary field. We thereby hope to pave the way for a collective, interdisciplinary knowledge base of concepts used to describe and assess individual’s pro-environmental dispositions and practices of green consumption. (shrink)

Recent studies show that psychiatry residents express a relatively greater need for ethics curricula than their colleagues in other specialties. Such studies have been limited in their generalizability because they were conducted at one site. This study of 151 psychiatry residents at seven U.S. psychiatry programs aims to address that limitation. Residents were surveyed on issues pertaining to ethics and professionalism education. Participants were found to support such curricula during training and to value its relevance to the practice of psychiatry. (...) Gender differences and the influence of the “hidden curriculum” on such results merit further study. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Approaching the End: Eschatological Reflections on Church, Politics, and Life by Stanley Hauerwas, and: Without Apology: Sermons for Christ’s Church by Stanley HauerwasLaura M. HartmanApproaching the End: Eschatological Reflections on Church, Politics, and Life Stanley Hauerwas grand rapids, mi: eerdmans, 2013. 251 pp. $24.00Without Apology: Sermons for Christ’s Church Stanley Hauerwas new york: seabury books, 2013. 169 pp. $18.00Stanley Hauerwas is prolific. By my count, there are forty-six (...) books to his name, including these two from 2013. And yet in the preface to Without Apology, he writes, “I am often asked, ‘How many books have you written?’ My truthful answer must be, ‘I have no idea.’ … I could count them, but I have no interest in doing so” (ix). Hauerwas’s reluctance to number his career in books shows his preference for smaller units of measurement (“how some reader may find this sermon, or that sentence or chapter … helpful”), but it also reflects his view that he is not the sole author of his works. To his credit, he mentions two influential women—his wife, Paula Gilbert, an experienced clergywoman, and his assistant, Carole Baker, who gives the sermons a “work-over” after they are written (ix).Those who know Hauerwas know what to expect from these volumes: thoughtful arguments that unflinchingly assert the centrality of Christ and of the Church; a heavy dose of pacifism; major appearances from John Howard Yoder and Karl Barth (as well as multiple cameos from fascinating authors who are now on my to-read list); and accessible, open prose outlining clear, thought-provoking arguments. The two books reviewed here are quite different from one another: Without Apology is a book of sermons; Approaching the End is a book of essays loosely organized around a theme of eschatology. But both contain the hallmarks of “classic Hauerwas”—his signature mix of virtue ethics, communitarian interests, and narrative sensibilities.Without Apology contains recent sermons, primarily in Episcopal churches. Drawing on lectionary readings, Hauerwas brings his own theological interpretation and creates fairly short, satisfying sermons, which he readily describes (in Paula Gilbert’s words) as “tight” (87). This collection also includes four sermons on the topic of priesthood and some other writings of note: the already-classic “An Open Letter to Christians Beginning College” (good for use with Christian undergraduates) and “Sexing the Ministry” (food for thought for [End Page 215] seminarian and clergy alike). Without Apology manifests several major themes, but the biggest of these connects with the title: Hauerwas is “unapologetic” about his Christian faith and doesn’t engage in theology of the “apologetic” style. His emphasis, rather, is on being truthfully present with one another in the church community.Approaching the End promises eschatological reflections and delivers on the promise. Although he is writing about eschatology, Hauerwas strongly maintains that he is not reaching his own “end” and disavows any contention that Approaching the End is a kind of “swan song” (xiv). He addresses politics and war in several chapters. In “The End of Sacrifice: An Apocalyptic Politics,” he makes the case that if Christians believe Jesus’s sacrifice was “the end of all sacrifices,” then we should not “continue to participate in the sacrifice of war” (36). Similar themes emerge in “War and Peace,” later in the volume. In “Church Matters: On Faith and Politics,” Hauerwas writes, “One of the challenges Christians confront is how the politics we helped create has made it difficult to sustain the material practices constitutive of an ecclesial culture to produce Christians” (68). He welcomes the “end” of churches and denominations as we know them because “it means that the church is finally free to be a politics” (86).Hauerwas also discusses the future of churches and denominations. “The End of Protestantism” reiterates that “if the church is to be faithful … then we must recover what it means for the church to be an alternative politics” (92). This chapter’s emphasis on Methodism and his appraisal of Methodists as “free church Catholics” (94) is of note. In “Which Church? What Unity?” Hauerwas discusses the ecumenical movement, prompted by George Lindbeck’s challenge to do so (98). Hauerwas’s... (shrink)

THIS ESSAY EXAMINES FEASTING AND FASTING IN LIGHT OF CHRISTIAN DEsires to eat as, with, and for Christ. Christ both fasted and feasted; Christians, in following his example, may embody him, encounter him, and eat in certain ways for his sake. In the Eucharist, Christians encounter and embody Christ, illuminating the ways that eating can be a holy practice. The Eucharist offers Christians transformative guidance and practical synthesis, allowing them to navigate the extremes of fasting and feasting. It encompasses and (...) enshrines both, allowing both enjoyment and abstention to be transformed into a fulfilled practice of consumption. Consuming Christ in the Eucharist helps Christians find ways to sanctify their consumption in other areas of life. (shrink)

Book reviewed in this article: Feminist Ethics. Ed. Claudia Card.

Following press disclosures in 1993 that U.S. government agencies had been using human subjects in tests and trials involving radioactive isotopes since the mid-1940s, a major national initiative to locate and declassify records concerning these tests was initiated. The U.S. Department of Energy, which led the declassification effort, pledged that a new “culture of openness” would attend the management of classified documents in the future. Following the attacks on the United States in September 2001, this momentum was reversed. Declassification initiatives (...) were delayed or terminated, and a significant portion of the many thousands of records about “human radiation experiments” during the 1940s and 1950s were removed from both online access, which had been in place since the mid-1990s, and from the public domain altogether. (shrink)

This article draws on in-depth case studies of 61 women and men of diverse sexual identities to show how gender, while apparently diminishing in significance, continues to shape interpretations and experiences of virginity loss in complex ways. Although women and men tended to assign different meanings to virginity, those who shared an interpretation reported similar virginity-loss encounters. Each interpretation of virginity—as a gift, stigma, or process—featured unequal roles for virgin and partner, which interacted with gender differences in power to produce (...) interpretation-specific patterns of gender subordination, only one of which consistently gave men power over women. (shrink)

Despite this virtue's history as an instrument of women's oppression, modesty, at its most basic, means voluntary restraint of one's power, undertaken for the sake of others. It is a mechanism that modifies unequal power relationships and encourages greater compassion and fairness. I use a Christian perspective with influences from Jewish and Muslim sources to examine modesty. The modest person, I argue, must be in relationship with others, must be honestly aware of her impacts on others, must be sensitive to (...) those impacts, compassionate toward others, and willing to hold back for others' sakes. Moreover, modesty is not only a virtue that pertains to sexuality and clothing, but it also can promote virtuous environmental behavior, particularly as it leads to awareness of, and sensitivity to, the effects of everyday behaviors on vulnerable others. (shrink)

We surveyed IRB chairs' perspectives on offering individual genetic research results to participants and families, including family members of deceased participants, and the IRB's role in addressing these issues. Given a particular hypothetical scenario, respondents favored offering results to participants but not family members, giving choices at the time of initial consent, and honoring elicited choices. They felt IRBs should have authority regarding the process issues, but a more limited role in medical and scientific issues.

Volume 20, Issue 5, June 2020, Page 26-28.

I examine the dynamics of measure development using two case studies: temperature, and health-related quality of life. I argue, following Bas van Fraassen and Leah McClimans that in each case these dynamics have a hermeneutic structure. Measure development is plagued by epistemic circularity, as is the task of interpreting a text, and similar strategies can be used in both measure development and hermeneutics to overcome that circularity. I show that Hans Georg Gadamer’s philosophical hermeneutics in particular are an effective lens (...) through which to examine the development of the temperature standard as described by Hasok Chang. Despite similar grounding in hermeneutics, I note an important difference between measure development for temperature and for health-related quality of life. Namely, while the meaning of temperature can be standardized, the meaning of health-related quality of life cannot. This standardization of meaning for the temperature concept represents a limit to the analogy with hermeneutics. Finally, I argue that the indeterminacy we find in health-related quality of life measurement is a result not only of analogy with the hermeneutic task, but of full-fledged participation in it. (shrink)

The paper analyses the argumentative structure of a difficult passage from Aristotle's Metaphysics XII 7 on the basis of a topos of sameness provided in Top. VII 1. In doing this the article gives an example of how Aristotle's treatises on dialectic can prove useful to understand what he says in his more philosophically committed writings. The article also shows how general argumentative techniques and more or less explicit specific philosophical assumptions interact in shaping Aristotle's arguments and how the distinction (...) of these different factors can help us have a better grasp on Aristotle's text. (shrink)