There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)

Volume 19, Issue 11, November 2019, Page 39-41.

As part of the regulatory review process, both the Food and Drug Administration and Office for Human Research Protections (U.S. Department of Health and Human Services [HHS]...

Informed Consent: What Must Be Disclosed and What Must Be Understood seeks to challenge the “standard view” of consent. It seeks to do so by segregating the “disclosure function” from the “understa...

The American Journal of Bioethics, Volume 12, Issue 6, Page 33-34, June 2012.

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

The case (Dawson et al. 2024) raises tensions between the ethical demands of respect for patient autonomy, patients’ clinical needs, and research to improve clinical care. Given burn patients’ urge...

Volume 20, Issue 10, October 2020, Page 39-41.

Genomic sequencing is becoming more common both in clinical practice and as a routine aspect of much research. Over the last 15 years there has been ongoing discussion about the implications of gen...

Volume 20, Issue 10, October 2020, Page 82-83.

Dans les stations de tourisme de montagne, les intersaisons correspondent à des creux d’activité durant lesquels les offres d’emploi alternatives sont peu nombreuses. Les saisonniers se trouvent donc confrontés à une période de chômage cyclique. Cette situation « intermédiaire », réunissant une forme d’incertitude de la relation d’emploi ainsi qu’une relative prévisibilité des périodes de recrutement n’est pas sans susciter certaines controverses. Dans ce contexte, comment sont vécues les phases de chômage saisonnier dans ces territoires? Ces séquences temporelles correspondent-elles à (...) un « temps mort » ou à un temps pluriel? Comment se négocie le temps pour soi dans le cadre d’embauches à contre-rythmes des temps sociaux dominants? Dans le cadre de cette forme d’emploi intermittente, le temps de chômage peut-il être conçu comme un temps de construction de la carrière professionnelle? Cet article s’intéresse aux formes d’adaptation aux rythmes d’emploi et de chômage des saisonniers en montagne et montre comment ces périodes hors-emploi participent de l’intériorisation de rythmicités spécifiques. (shrink)

This article studies the conceptions of social justice of women active in transnational migrant politics over a period of roughly 20 years in the Netherlands. The novel focus on migrant women reveals that transnational politics is almost completely male-dominated and -directed. Two of the exceptions found in this article include a leftist and a Kurdish women organization supporting the communist cause in the 1980s and the Kurdish struggle in the 1990s in Turkey, respectively. In both organizations gender equality was subordinated (...) to broader ideologies of political parties in their homeland. Leftist activists in the cold war era supported a narrow definition of the "politics of redistribution," while and Kurdish activists, combined classical features of the latter with those of traditional identity politics. (shrink)

“Faculty of Language: the ‘Assembly-Only Hypothesis’ and Domain Specificity”. The faculty of language was always considered as the paradigm of a cognitive capacity that illustrates the property of domain specificity. In the minimalist-biolinguistic approach, this property seems to blur. However, the reason usually cited, does not seem adequate from the point of view of the conceptual coherence of the notion of domain specificity. In this paper I will distinguish between a sense of specificity of domain that is interesting or useful (...) for cognitive research and another vacuous one. I will show that if the analysis of the notion of domain specificity is conceptually coherent and the available empirical evidence is accepted, then these constitute the reasons why domain specificity cannot be attributed to the faculty of language under the assembly-only hypothesis. (shrink)

This case is about a study of burn patients that included a request to the IRB for a waiver of consent for perianal specimen collection–a request which ultimately was not approved by a reviewing IR...

As medicine and science advance, new ethical questions emerge. Over time, deliberation and analysis result in a somewhat settled approach to a problem. Often the settled approach is based on group...

Volume 20, Issue 4, May 2020, Page 111-113.

The American Journal of Bioethics, Volume 12, Issue 10, Page 18-20, October 2012.

Volume 19, Issue 10, October 2019, Page 97-98.

Methodologies of poststructuralist theory and critical social theory may be appropriated for nursing research and practice. Researchers using either methodology employ an analysis of power to explore experiences in various fields, and raise issues diat are highly relevant to nursing. However, the two methodologies differ and, often, die respective dieories are sharply opposed. In diis paper, die differences bodi from widiin and between each approach are explored, showing dieir tensions and limits. I contend that a reflexive approach to discourse analysis (...) provides insight into some of die methodological challenges diat arise in die context of bodi dieories. It is argued diat die differences between poststructuralism and critical social dieory seem likely to be mellowed by encounters diat treat each other with respect. To some extent, such encounters may tend to converge die two positions. (shrink)

Hornsby defiende una interpretación muy particular de la distinción personal-subpersonal tal como fue propuesta por Dennett y de la doctrina filosófica en la que está enraizada esta distinción. Según Hornsby de la aceptación de la distinción y la doctrina se sigue una defensa de la autonomía explicativa del nivel personal. Esta defensa nos compromete con un nivel personal genuino de explicación y la idea de que los hechos subpersonales no explican hechos personales. Hornsby sostiene, además, que mientras que en Dennett (...) se defiende la autonomía del nivel explicativo personal, en Dennett post-1969 al modificarse la doctrina de base cambia la manera de entender la distinción y con ello se reniega de ambos compromisos, de lo cual se sigue un abandono de la tesis de la autonomía del nivel explicativo personal. La tesis que vamos a sostener en este trabajo es que si bien la distinción de Dennett nos compromete con , no nos compromete con . Dado que una defensa de la autonomía explicativa del nivel personal, tal como Hornsby la entiende, abarca ambos compromisos, se sigue que no hay tal defensa. En consecuencia, si bien hay algunas cuestiones que en Dennett no se plantean de manera tan explícita y clara como en Dennett post-1969, no hay un cambio sustancial en su concepción de la distinción.According to Hornsby , Dennett's personal-subpersonal distinction has as one of its consequences a defense of the autonomy of personal level explanation, and this defense is based on two commitments: the personal level is a genuine level of explanation, and subpersonal facts do not explain personal facts. Moreover, Hornsby argues that Dennett post-1969 rejects both commitments, and that he consequently abandons the autonomy thesis. In this paper we shall argue that, although Dennett's distinction is committed to , it is not committed to . Given that a defense of the autonomy, as Hornsby understands it, presupposes both commitments, it follows that there is no such defense. We hold that there is no substantial change in Dennett's conception of the distinction, although some of these issues are not as clear and explicit in Dennett 1969 as in Dennett post-1969. (shrink)

In this paper Grice's requirements for assertability are imposed on the disjunction of Classical Logic. Defining material implication in terms of negation and disjunction supplemented by assertability conditions, results in the disappearance of the most important paradoxes of material implication. The resulting consequence relation displays a very strong resemblance to Schurz's conclusion-relevant consequence relation.

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, for (...) 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

Emergency nurses apply specialist knowledge to the practice of emergency care. This paper discusses the ways in which three emergency nurses understand the nature of their care from their own frames of reference and experiences and presents some of the data collected in a larger study. Various discourses, which compete to inform emergency nurses' understandings of practice, are linked with the notion of nurses as subjects; that is, each discourse may inform, shape and constitute the practice of the nurse and, (...) in turn, the ways in which the patient comes to be known and understood. I will examine the ways in which emergency nurses come to experience or position themselves vis‐à‐vis extant forms of knowledge of emergency care and the extent to which they articulate new or distinctive formulations of emergency care. This paper illuminates the commonalities that constitute the discourses of emergency nursing care, and also analyse nurses' language which demonstrates that within each discourse variations, contradictions and resistances exist. Emergency nursing care occurs in a context of a biomedical discourse that dominates, or tends to dominate, the work of the emergency setting and so to determine acceptable or possible practices. Nevertheless, nurses contest in various ways the ‘truths' that they understand to underpin their practice. Challenges to biomedical discourses are revealed, to some extent, by drawing attention to specific situations and particular struggles encountered in emergency nurses' everyday practice. (shrink)

Narrative has proven itself a continuous as well as adaptable means for environmentally oriented expression. Its role goes beyond the mediation of pre-existing knowledge imported into the realm of storytelling from other domains; rather, influential models of the natural world tend to circulate as storyworlds. This special issue of SubStance proceeds from the premise that narratives are not only a sequence of signs encoding a story but also “invisible, elusive representations that exist only in the mind”. Narrative forms generate and (...) transfer environmental knowledge; moreover, any specifically narrative concerns are important contributing factors to the models of agency, change... (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

This paper is a contribution to the program of constructing formal representations of pragmatic aspects of human reasoning. We propose a formalization within the framework of Adaptive Logics of the exclusivity implicature governing the connective ‘or’.Keywords: exclusivity implicature, Adaptive Logics.

The ‘managed care’ idea: implications for health service systems in Australia The growth of corporatism in health‐care in the US, and the consequences arising from US models of health‐care delivery systems provide an enormously valuable point of comparison with health systems of other developed economies, such as Australia. If lessons are to be learnt from the US, then an analysis of the structure and performance of the US health‐care system provides important background for understanding and assessing contemporary policy changes to (...) administrative and organizational designs and techniques for patient care in Australia. (shrink)

El realismo intencional acérrimo quiere dos cosas que, según intentaré mostrar, son difíciles de lograr conjuntamente: estados con contenido semánticamente interpretable y que tengan rol causal en la producción de la conducta. Si bien no hay dificultades para obtener, el problema es con. La estrategia del RIA consiste en postular la existencia de leyes intencionales causales. El problema es que esas leyes son de un estatus dudoso, al punto que muchos consideran que no son posibles y ni siquiera necesarias. Según (...) el RIA, si no se puede obtener conjuntamente y se desprenderían dos consecuencias indeseables: si los estados intencionales no tienen rol causal qua intencionales significaría que no se es realista acerca de las creencias y deseos; y que no sean posibles las leyes intencionales implicaría que no se puede tener una psicología científica. En la primera parte del trabajo me ocuparé de exponer las tesis del RIA y mostraré que no puede cumplir conjuntamente con las exigencias y. En la segunda parte me ocuparé de defender la idea de que del hecho de que no se pueda conciliar y no se sigue un eliminativismo acerca de los estados intencionales ni la imposibilidad de que la psicología sea una ciencia. The Hairy Intentional Realism aims for two things that I shall try to show are difficult to jointly obtain: states with an interpretable semantic content, and with causal role in the production of behavior. There is no difficulty in obtaining, the problem is with. HIR's strategy consists in the postulation of causal intentional laws. The problem is that these laws have a doubtful status to the point that many consider them not possible and not even necessary. According to HIR, if and cannot be jointly obtained, two unwanted consequences emerge: if intentional states do not have a causal role qua intentional, that would mean ceasing to be realistic about them; and if intentional laws are not possible that would imply that we could not have a scientific psychology. In the first part of this paper I shall exhibit HIR's main theses and I shall show that it cannot accomplish the two demands. Second, I shall defend the idea that because of the fact that and cannot be reconciled, neither an eliminativism about intentional states, nor the impossibility that psychology is a science can follow. (shrink)

This paper examines how three Dutch political parties employ the Internet as a tool to enhance ‘digital democracy’. The potential of digital democracy is considered to be strongest in the sphere of collective action outside the domain of political institutions. In this article, however, attention is given to how institutionalized channels might be supportive of digital democracy. Three components of the democratic process – information provision, deliberation, and political decision-making – are examined in the content and user assessments of the (...) web sites of the Socialist Party, the Christian Democratic Party and the Green Party. Minor differences were found in the party web sites regarding information provision; substantial differences were found regarding the degree and nature of political deliberation available on the sites. Indicators of the third component, political decision-making, were least evident on all three web sites. User assessments of the sites and opportunities for political deliberation followed, more or less, the general public images of the related political parties. (shrink)

Although the personal-subpersonal distinction was first proposed in 1969 by D. Dennett, it has been approximately in the last ten years that it has received in­creasing attention and has became a widely used distinction particularly in the philosophy of mind and cognitive psychology literature. While the distinction is ubiquitous there are a few recent proposals about the relationship between the levels, namely, inter alia, the mixed horizontal explanation (Bermúdez 2000), the semantic view of computation (Peacocke 1994), and interaction without reduction (...) (Davies 2000a, b). In this paper I will first describe the way of understanding the distinction shared by the proposals aforementioned. Second, I will show some of the difficulties facing each proposal. Finally, I will suggest what I consider are the misleading assumptions that are at the root of the proposed strategies of inter-level relations. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV as well (...) as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the difficulty of even engaging with community members in oppressive settings, where authorities severely restrict civil liberties of PWID so that even discussing issues related to drug use and enforcement may place individuals at risk. To overcome such limitations, he appropriately suggests interviewing confidentially those who have previously been detained in closed settings as part of the community engagement process. Similarly, Wolfe observes that critical issues can be overlooked with a narrow focus on study procedures if contextual factors before, during or after a study are ignored. For example, he cites the risk of overdose for study participants who have been abstinent during a study and subsequently resume injecting when the study concludes. These kinds of risks may not be obvious …. (shrink)

In the Philosophy of Cognitive Science, it is a common held view that the modularity hypothesis for cognitive mechanisms and the innateness hypothesis for mental contents are conceptually independent. In this paper I distinguish between substantial and deflationist modularity as well as between substantial and deflationist innatism, and I analyze whether the conceptual independence between substantial modularity and innatism holds. My conclusion will be that if what is taken into account are the essential properties of the substantial modules, i.e. domain (...) specificity and informational encapsulation, then it seems to be such independence. However, if what is taken into account is the function of the substantial modules, then it seems to be a conceptual connection from modularity to substantial innateness. (shrink)

This chapter contains sections titled: Metaphysical Approaches Metaphysical Problems References.

Entre los filósofos que consideran que pensamos utilizando representaciones simbólicas, P. Carruthers ha defendido, versus la hipótesis del ‘lenguaje del pensamiento’ (LDP), una versión débil de la hipótesis del ‘pensamiento en lenguaje natural’ (PLN). En este trabajo, me ocuparé, en primer lugar, de mostrar las razones por las cuales Carruthers, en su defensa de la hipótesis débil del PLN, siembra cierta confusión en la polémica entre el LDP y PLN. En segundo lugar, intentaré esbozar una salida de esta confusión, ofreciendo (...) y evaluando dos opciones posibles, i.e. la estrategia trascendental y la de la inferencia a la mejor explicación revisada, para quien desee sostener una versión débil del PLN que no desvirtúe la polémica.Among the philosophers who believe that we think with symbolic representations, P. Carruthers has defended -against the ‘language of thought’ hypothesis (LOT)- a weak version of the ‘thinking in natural language’ hypothesis (TNL). In this paper, I will firstly state the reasons why I think that Carruthers throws the LOT-TNL debate into some confusion. Secondly, I will try to outline a way out of this confusion, offering and evaluating two possible options -i.e., the transcendental and the revised inference to the best explanation strategies- for those who wish to hold a weak version of TNL that does not distort the debate. (shrink)