The dialectic of light and darkness studied in this collection of essays reveals itself as a primal factor of life as well as the essential element of the specifically human world. From its borderline position between physis and psyche, natural growth and techne, bios and ethos, it functions as the essential factor in all the sectors of life at large. We see its crucial role in all sectors of life while, prompted by man's creative imagination, it enhances and spurs his (...) vital as well as societal and spiritual life. This rare collection contains studies by Thomas Ryba, Krystina Górniak-Kocikowska, Lois Oppenheim, Sydney Feshback, Eldon van Lieve, Sitansu Ray, Theodore Litman, Peter Morgan, Colette Michael, Christopher Lalonde, L. Findlay, Christopher Eykman, Beverly Schlack Randles, Jorge García-Gómez, William Haney, Sherilyn Abdoo, David Brottman, Alan Pratt, Hans Rudnick, George Scheper, Freema Gottlieb, Marlies Kronegger. (shrink)

Individuals with major depression may benefit from psychiatric treatment, yet they may refuse such treatment, sometimes because of their depression. Hence the question is raised whether such individuals are competent to refuse psychiatric treatment. The standard notion of competence to consent to treatment, which refers to expression of choice, understanding of medical information, appreciation of the personal relevance of this information, and logical reasoning, may be insufficient to address this question. This is so because major depression may not impair these (...) four abilities while it may disrupt coherence of personal preferences by changing them. Such change may be evaluated by comparing the treatment preferences of the individual during the depression to his or her treatment preferences during normal periods. If these preferences are consistent, they should be respected. If they are not consistent, or past treatment preferences that were arrived at competently cannot be established, treatment refusal may have to be overridden or ignored so as to alleviate the depression and then determine the competent treatment decision of the individual. Further study of the relation between depression and competence to refuse or consent to psychiatric treatment is required. (shrink)

Dialogical ethics are a procedural alternative to substantive ethics such as consequentialism, deontology, principlism, casuistry, virtue ethics and care ethics. Dialogical ethics are procedural in that they do not establish goods in advance, unlike substantive ethics, but rather determine goods through a procedure enacted by the actual parties involved (although some substantive notion of justice may still be required); and they are dialogical in that the procedure is that of dialogue, involving both empathic critical discussion and negotiation. A fundamental tenet (...) of dialogical ethics may be the use of appropriate rules of order regulating dialogue among the parties involved. Some of the central characteristics of such rules of order are that they are reciprocally regulated by dialogue, that they override other ethical considerations, and that they institute empathic critical discussion and negotiation within the ethical dialogue. Dialogical bioethics are the application of dialogical ethics to ethical problems in medicine. The approach of dialogical bioethics has proven fruitful for resolving bioethical problems such as that of medical futility, where approaches of substantive ethics have reached an impasse. There is room for further study of special challenges within dialogical bioethics, such as the incompetence of some involved parties, conflicts of interests of third parties, and the cost-effectiveness of this ethical approach. (shrink)

Jakovljevic and Crnčevic review the concept of comorbidity in relation to mental disorders, which is timely. Yet they seem to ignore a longstanding and important notion of comorbidity, highlighted in psychiatry particularly by Sigmund Freud. The ignored notion is that of compensatory comorbidity. Compensatory comorbidity is a special case of compensatory phenomena in relation to disrupted health.

The relation between the notions of (medical) invasiveness and (actual or potential) harm has not been systematically discussed nor theoretically grounded, despite its importance to clinical-ethical practice. This paper aims to clarify the notion of invasiveness beyond the traditional notion of invasiveness as breaking skin or inserting mechanical objects into the body. The traditional notion of invasiveness is challenged by counterexamples. Three approaches to the notion of disorder applied here are: deviation from what is common; deviation from what is considered (...) ideal; and disruption of self-organization. Assuming that more extreme measures are related to more harm, all three approaches to the notion of disorder suggest that invasiveness is proportional if not identical to harm, and show no clear relation to the traditional notion of invasiveness. In conclusion, the notion of invasiveness may best be eliminated from medical terminology, replacing it with a detailed understanding of the notion of harm. (shrink)

Improving nitrogen (N) fertilizer management in agricultural systems is critical to meeting environmental goals while maintaining economically viable and productive food systems. This paper applies a farm systems framework to analyze how adoption of N management practices is related to different farming operation characteristics and the extent to which fertilizer, soil and irrigation practices are related to each other. We develop a multivariate probit regression model to analyze the interdependency of these adoption behaviors from 966 farmers across three watersheds and (...) diverse cropping systems in the Central Valley of California. Our analysis demonstrates that farmers adopt varying combinations or portfolios of practices, with the most common portfolio featuring a core set of fertilizer-focused practices. Irrigation infrastructure is an especially important farm operation characteristic for encouraging adoption of innovative practice portfolios that integrate water and fertilizer management. These findings highlight the ability for a farm systems approach to improve our understanding of farmer decision-making across diverse agricultural landscapes. (shrink)

Contemporary biological psychiatry is in a seemingly inchoate state. I assert that this state of biological psychiatry is due to its violation of an epistemological criterion of rationality, i.e., the relevance criterion; that is, contemporary biological psychiatry is irrational as it adopts a conception irrelevant to the psychobiological domain. This conception is mechanistic. The irrationality of biological psychiatry is manifest as the dominance of neurochemical explanations of psychopharmacological correlations, resulting in predictive sterility and, correspondingly, in the dominance of serendipity. I (...) suggest a rationalization of biological psychiatry through a conception relevant to the psychobiological domain. This conception is hierarchical. Keywords: criterion of relevance, epistemology, hierarchical conception, mechanistic conception, rationality CiteULike Connotea Del.icio.us What's this? (shrink)

Informed consent to breaking (or waiving) bad news is an important yet neglected topic. It is distinct from informed consent to diagnosis and to treatment, and may be logically and ethically sound, provided patients are competent and that no considerable harm may be caused to others by breaking or waiving bad news to patients. This requires a differential assessment procedure in order to balance patient autonomy, benefit and justice towards others, preferably exploring patients’ values, expectations and needs with them, so (...) that an acceptable decision can be made on whether to act on their consent to breaking or waiving bad news, or to ignore it and act on informed consent by proxy. Future study should attempt to provide a detailed characterization of procedures for attaining informed consent to breaking or waiving bad news, and to test their success in establishing ethically sound health care. (shrink)

A meta-ethical analysis demonstrates that care ethics is a grounded in a distinct mode of moral reasoning. This is comprised primarily of the rejection of principles such as impartiality, and the endorsement of emotional or moral virtues such as compassion, as well as the notion that the preservation of relations may override the interests of the individuals involved in them. The main conclusion of such a meta-ethical analysis is that such meta-ethical foundations of care ethics are not sound. Reasonable alternatives (...) for care ethics may be its formulation as an additional principle within an established principlist framework, or the move to a dialogical ethics, where the good to be acted upon is not decided in advance but rather critically discussed and established within the encounter of the parties involved. (shrink)

This study examines the ends of medical intervention and argues that mainstream contemporary medicine assumes that appropriate ends may be discovered (i.e., naturalism), rather than created or decided upon (i.e., conventionalism). The essay then applies these considerations to the problem of the demarcation of the normal from the pathological. I argue that the common formulations of this dispute commit a fallacy, as they characterize the "normal" as a state of the organism and not as an ongoing process within it. Such (...) a process may be characterized as self-creation and self-repair. Such considerations support the conclusion that normality may be regarded as a regulative idea, rather than as an end-state, and as part of the ends of medical intervention, depending upon choice and context. (shrink)

It is only in the past 20 years that the concept of 'recovery' from mental health has been more widely considered and researched. This book is unique in addressing philosophical issues - including conceptual challenges and opportunities - raised by the notion of recovery of people with mental illness.

This article argues that the failure of certain theories of reflexive identity transformation to consider more fully issues connected to gender identity leads to an overemphasis on the expressive possibilities thrown up by processes of detraditionalization. By ignoring certain deeply embedded aspects, some theories of reflexive change reproduce the `disembodied and disembedded' subject of masculinist thought. The issues of disembodiment and disembeddedness are explored through a study of the work of Pierre Bourdieu on `habitus' and the `field'. The idea of (...) habitus yields a more dynamic theory of embodiment central to a feminist understanding of gender identity as a durable but not immutable norm. The idea of the `field' provides a more differentiated analysis of the social context in which the reflexive transformation of gender identity unfolds. This in turn offers a way of thinking of possible transformations within gender identity as uneven and non-synchronous phenomena. (shrink)

Biological psychiatry has been dominated by a psychopharmacologically-driven neurotransmitter dysfunction paradigm. The objective of this paper is to explore a reductionist assumption underlying this paradigm, and to suggest an improvement on it. The methods used are conceptual analysis with a comparative approach, particularly using illustrations from the history of both biological psychiatry and molecular biology. The results are that complete reduction to physicochemical explanations is not fruitful, at least in the initial stages of research in the medical and life sciences, (...) and that an appropriate (non-reducible) integrative principle - addressing a property of the whole system under study - is required for each domain of research. This is illustrated in Pauling's use of a topological integrative principle for the discovery of the functioning of proteins and in Watson and Crick's use of the notion of a genetic code as an integrative principle for the discovery of the structure of genes. The neurotransmitter dysfunction paradigm addresses single molecules and their neural pathways, yet their interactions within the CNS as a whole seem most pertinent to mental disorders such as schizophrenia. The lack within biological psychiatry of an integrative principle addressing a property of the CNS as a whole may be responsible for the empirical failure of orthomolecular psychiatry, as well as for the central role that serendipity has played in the study of mental disorders, which is dominated by the neurotransmitter paradigm. The conclusion is that research in biological psychiatry may benefit from using, at least initially, some integrative principle(s) addressing a property of the CNS as a whole, such as connectionism or a hierarchical notion. (shrink)

"Foucault: A Critical Introduction offers a comprehensive and accessible introduction to the work of one of the twentieth century's most influential thinkers. Unlike most books on Foucault, this book offers an assessment of all Foucault's work, including his final writings on governmentality and the self. McNay argues that the later work initiates an important shift in his intellectual concerns which alters any retrospective reading of his writings as a whole." "Throughout, McNay is concerned to assess the normative and political implications (...) of Foucault's social criticism. She goes beyond the level of many commentators to look at the values from which Foucault's work springs, and reveals the implicit assumptions underlying his social critique. McNay also discusses Foucault's position in the modernity/postmodernity debate, his own ambivalence toward Enlightenment thought and his place in recent developments in feminist and cultural theory. The result is an invaluable book which clearly outlines the central themes of Foucault's work, while offering a fresh appraisal of his thought."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Johannes Scottus Eriugena ragt als ein der Antike kongenialer Denker mit seinem originellen theologisch-philosophischen Entwurf von Gott und Welt weit über seine Zeitgenossen des 9. Jahrhunderts hinaus. Die vorliegende Untersuchung arbeitet die zentrale Bedeutung des freien Willens und einer optimistischen Sicht der Schöpfung für das Gesamtsystem heraus und zeigt inhaltliche Parallelen zwischen dem Werk des frühmittelalterlichen Autors und seiner irisch-keltischen Herkunft auf.

Practical and evidence-based, this unique book is the first comprehensive text focused on person-centered approaches to people with serious mental illness such as schizophrenia and bipolar disorder. It reflects a range of views and findings regarding assessment, treatment, rehabilitation, self-help, policy-making, education and research. It is highly recommended for all healthcare professionals, students, researchers and educators involved in general practice, psychiatry, nursing, social work, clinical psychology and therapy. Healthcare service providers, and policy makers and shapers, will find the book's wide-ranging, (...) multi-professional approach enlightening. 'Serious Mental Illness reflects a continued distancing from the outmoded and unsubstantiated belief that people with severe mental illnesses could not recover, and that they would respond positively only to goals and treatment plans chosen, designed and implemented by providers in order to prevent their further deterioration. Anyone with an interest in the concept of person-centered approaches will discover new ideas in this book. Indeed, anyone with an interest in person-centered approaches has to read this book. Not only is it the first such book on person-centered approaches, but it will serve as the gold standard in this topic area for years to come.' William A Anthony, in the Foreword. (shrink)

This paper shows how the mythology surrounding rape enters into a criterion of reasonableness which operates through the legal system to make women vulnerable to unscrupulous victimization. It explores the possibility for changes in legal procedures and presumptions that would better serve women's interests and leave them less vulnerable to sexual violence. This requires that we reformulate the criterion of consent in terms of what is reasonable from a woman's point of view.

Schlusslogische Letztbegründung is a collection of essays in honor of Kurt Walter Zeidler. Mr. Zeidler is a distinguished Kant- and Neo-Kantian-scholar who has reconstructed Kant's concept of transcendental logic in connection with the logic of the concept of Hegel and the logic of symbolization of Peirce. (cf. Zeidler: Grundriss der transzendentalen Logik, 3rd ed., Wien 2017) He has most notably inquired intensively into the relation of transcendental logic to philosophy of science (cf. Zeidler: Prolegomena zur Wissenschaftstheorie, Wien 2000) and to (...) phenomenology (cf. Zeidler: Vermittlungen. Zum antiken und neueren Idealismus, Wien 2016). He has also published several studies on Neo-Kantianism (cf. Zeidler: Provokationen. Zu Problemen des Neukantianismus, Wien 2018). This is refelected in the collection of essays by distinguished scholars who discuss and critically examine Zeidler's work. It includes contributions by Steinar Mathisen (Oslo), Wolfdietrich Schmied-Kowarzik (Vienna), Werner Flach (Lichtenau), Thomas Knoppe (Straberg), Geert Edel (Wyk/Föhr), Martin Bunte (Münster), Reinhard Hiltscher (Dresden), Walter Tydecks (Bensheim), Christian Krijnen (Amsterdam), Hartwig Wiedebach (Zürich), Max Gottschlich (Linz), Thomas Sören Hoffmann (Hagen), Rudolf Meer (Kaliningrad), Hans-Jürgen Müller (Frankfurt am Main), Robert König (Vienna), Ulrich Blau (Marburg), Karen Gloy (Luzern/Munich), Reinhold Breil (Aachen), Erhard Oeser (Vienna), Hans-Dieter Klein (Vienna), Hans Martin Dober (Tübingen), Kurt Walter Zeidler (Vienna) and Lois Marie Rendl (Vienna). (shrink)

This article aims to clarify the notion of a psychiatric disability. The article uses conceptual analysis, examining and applying established definitions of (general) disability to psychiatric disabilities. This analysis reveals that disability as inability to perform according to expectations or norms is related to impairment as deviation from the (statistical) norm, while disability as inability to achieve (personal) goals is related to impairment as deviation from the (personal) ideal. These two views of impairment and disability are distinct from the self-organization (...) view of impairment as disrupted self-creation or disrupted self-repair and of disability as disrupted whole person self-compensation (in relation to an impairment). All these three views of disability pertain to psychiatric disability. Although there is nothing necessarily psychiatric about psychiatric disability other than the psychiatric impairment related to it, the life course and life circumstances typical of many people with (severe) psychiatric disorders may lead to disability and may thus confer some (psychiatric) specificity on this disability. This analysis may facilitate research on specific psychiatric disabilities and a broader scope for psychiatric rehabilitation. (shrink)

In the fall semester of 1772/73 at the Albertus University of Königsberg, Immanuel Kant, metaphysician and professor of logic and metaphysics, began lectures on anthropology, which he continued until 1776, shortly before his retirement from public life. His lecture notes and papers were first published in 1798, eight years after the publication of the _Critique of Judgment, _the third of his famous _Critiques. _The present edition of the _Anthropology _is a translation of the text found in volume 7 of _Kants (...) gesammelte Schriften, _edited by Oswald Külpe. Kant describes the _Anthropology _as a systematic doctrine of the knowledge of humankind. Kant’s lectures stressed the "pragmatic" approach to the subject because he intended to establish pragmatic anthropology as a regular academic discipline. He differentiates the physiological knowledge of the human race—the investigation of "what Nature makes of man"—from the pragmatic—"what man as a free being makes of himself, what he can make of himself, and what he ought to make of himself." Kant believed that anthropology teaches the knowledge of humankind and makes us familiar with what is pragmatic, not speculative, in relation to humanity. He shows us as world citizens within the context of the cosmos. Summarizing the cloth edition of the _Anthropology_,_ Library Journal_ concludes: "Kant’s allusions to such issues as sensation, imagination, judgment, taste, emotion, passion, moral character, and the character of the human species in regard to the ideal of a cosmopolitan society make this work an important resource for English readers who seek to grasp the connections among Kant’s metaphysics of nature, metaphysics of morals, and political theory. The notes of the editor and translator, which incorporate material from Ernst Cassirer’s edition and from Kant’s _marginalia _in the original manuscript, shed considerable light on the text.". (shrink)

Embedded pragmatic clinical trials (PCTs), like other types of randomized comparative-effectiveness research (CER) studies, are sometimes conducted without informed consent. Indeed, authors of both...

Background Ethics consultations are established in contemporary health care. Informal ethics consultations often occur and are possibly beneficial, yet they have not been empirically studied. We sought to describe features of informal ethics consultations and to identify facilitators and disruptors of patient participation in such ethics consultations. Methods We used a mixed methods (quantitative and qualitative) evaluation design and conveniently sampled 64 sequential informal ethics consultations over a period of 3 years in two academic health care centers in one city (...) in Canada. Data were collected by the two participating ethicists. We used statistical description for the quantitative data and thematic analysis for the qualitative data. Results Patients participated in only two (3%) of the informal ethics consultations. Factors that disrupted patient participation in ethics consultations were related to patients’ issues (mental impairments), family issues (family withholding information from the patient), and team members’ issues (efficiency considerations). Conclusion Informal ethics consultations may be used for ethics capacity building of health care providers rather than for engagement with addressed patients. Further research on informal ethics consultations is required, including in different sites. (shrink)

abstract Ethicists such as Peter Singer argue that consciousness and self‐consciousness are the principal considerations in discussing the use of animals by humans, such as in medical experiments. This paper raises an additional consideration to factor into this ethical discussion. Ethics deal with the intentional impact of subjects on each other. This assumes a meta‐representational ability of subjects to represent states of mind of others, which may be termed other‐consciousness. The moral weight of other‐consciousness is manifest in the notion of (...) responsibility, where humans lacking in other‐consciousness (such as individuals with autism) may not be held responsible for their harmful actions towards others. As responsibility implies not only duties but also rights and more generally high moral status, it follows that other‐consciousness grants high moral status, other things being equal — recognizing that other factors grant moral status too. Other‐consciousness also increases the capacity for suffering, both due to increased freedom (and consequently increased possibility of restriction of freedom) and to increased empathy (with suffering of others). Hence, the more an animal is other‐conscious, the more it deserves high moral status and the more it can suffer, other things being equal, and consequently, the less it should be used for human purposes. Further study is required to elucidate to what extent animals used by humans, such as in medical experiments, particularly primates and other highly evolved mammals, are other‐conscious. (shrink)

Deviant forms of human thought may provide insight into epistemic standards, such as rationality. A comparative analysis of paranoia and reinforced dogmatism suggests that reinforced dogmatism, such as pseudo-science a-la-Popper, demonstrates a primary epistemic lack of critical rationality, that is, of testability, whereas paranoia demonstrates a lack of range of alternative statements leading secondarily to a lack of testability. This reflects the importance to both epistemology and psychiatry of epistemic standards in addition to testability, such as relevance to problems, and (...) emphasizes the distinction of the context of introduction from the contexts of discovery and of justification. Key Words: context of introduction • paranoia • reinforced dogmatism • relevance • testability. (shrink)

This article considers Foucault’s analysis of ordoliberal and neoliberal governmental reason and its reorganization of social relations around a notion of enterprise. I focus on the particular idea that the generalization of the enterprise form to social relations was conceptualized in such exhaustive terms that it encompassed subjectivity itself. Self as enterprise highlights, inter alia, dynamics of control in neoliberal regimes which operate through the organized proliferation of individual difference in an economized matrix. It also throws into question conceptions of (...) individual autonomy that underpin much political thought and upon which ideas about political resistance are based. Self as enterprise also problematizes the viability of Foucault’s later work on ethics of the self as a practice of resistance. I go on to argue that Foucault’s discussion of an unresolved clash in civil society between monarchical and governmental power, between law and norm, offers an elliptical but more promising account of opposition to normalizing bio-power. (shrink)

Bioethics uses various theories, methods and institutions for its decision-making. Lately, a dialogical, i.e., dialogue-based, approach has been argued for in bioethics. The aim of this paper is to explore some of the decision-making processes that may be involved in this dialogical approach, as well as related pitfalls that may have to be addressed in order for this approach to be helpful, particularly in clinical ethics. Using informal logic, an analysis is presented of the notion of dialogue and of the (...) stages of dialogical decision-making, and then processes and related pitfalls associated with these stages in the context of clinical ethics are examined. The results of this exploration are expected to facilitate the implementation and empirical testing of dialogical bioethics. (shrink)

In today’s multi-cultural world and global economy, attention is often focused on the diversity of cultural values and practices and the need for management approaches to take these differing cultural environments into account. While there is much to be valued in this approach, the focus is often on how to navigate through distinct cultural practices in order to achieve a singular business aim, which falls within the current neoliberal paradigm of global trade. In addition, by focusing on differences in cultural (...) practices, rather than on similarities in underlying values, this approach fails to utilize an important way to achieve a greater degree of global integration in management. Despite striking cultural differences, it is possible to identify some enduring values that underlie what often appear to be quite discrete value paradigms, especially by looking at value paradigms that have endured for centuries, even millennia. This paper proposes to explore the values embedded in two such value paradigms or religious traditions, zen buddhism and Judaism, describing crucial core values in each and comparing and contrasting their ethical frameworks, in order to be able to evaluate their utility in today’s world and especially their significance for creating a more holistic, inclusive, and responsible management framework. The paper will begin by explicating the set of foundational values in each religious tradition. For example, zen buddhism, especially as expressed by Vietnamese monk Thich Nhan Hanh, utilizes the concepts of engaged mindfulness and inter-being to demonstrate the ways in which all global issues are linked together, and the collective responsibility that all humans bear for the state of our planet and the beings who live on it. This approach is inherently holistic and inclusive, and requires a management approach that takes into account the moral responsibility that we all carry. Likewise, the Jewish tradition, while using quite different terminology, also lays out a holistic and inclusive moral vision. Key concepts include the values of Tikkum Olam, to repair the world, and Tsedakah, which literally means justice or righteousness, but is commonly used to indicate charitable giving. The first value, to repair the world, emphasizes the collective moral responsibility to heal whatever damage has been done to the world in order to make the it a better place for all. It does not matter who has done the damage; what matters is each person’s obligation to improve the status quo, under the assumption that all our fates are linked together. The second value, justice and charity, is also considered to be a moral obligation, not simply a voluntary act of charity. The emphasis here is on anonymous giving, done in order to help others and without any expectation of receiving some benefit, such as positive publicity. As a moral obligation, it is not something that one should benefit from. Thus, the concept of tsekakah also emphasizes the inter-connectedness of all humanity. In addition, in the Torah, there are a series of rules about how to deal with others in business as well as the obligation, during harvest-time, to leave some grain in the fields for the less fortunate. In all, we see a focus on being mindful of others, on seeing our fates as interconnected, as in zen buddhism. The last section of the paper will explore some of the ways in which these moral imperatives can be utilized to undergird and buttress a more holistic, inclusive and responsible management approach. Some management models already include moral imperatives, such as corporal social responsibility, and this section will explore in greater detail how the above concepts have been more fully integrated into current management models. (shrink)

The concept of the digital phenotype has been used to refer to digital data prognostic or diagnostic of disease conditions. Medical conditions may be inferred from the time pattern in an insomniac’s tweets, the Facebook posts of a depressed individual, or the web searches of a hypochondriac. This paper conceptualizes digital data as an extended phenotype of humans, that is as digital information produced by humans and affecting human behavior and culture. It argues that there are ethical obligations to persons (...) affected by generalizable knowledge of a digital phenotype, not only those who are personally identifiable or involved in data generation. This claim is illustrated by considering the health-related digital phenotypes of precision medicine and digital epidemiology. (shrink)

This paper evaluates four recent randomized clinical trials in which the informed consent of participants was either not sought at all, or else was conducted with critical information missing from the consent documents. As these studies have been taking place, various proposals to conduct randomized clinical trials without consent have been appearing in the medical literature. Some of the explanations offered for why it is appropriate to bypass consent or disclosure requirements appear to represent a fundamental misunderstanding of applicable government (...) regulations and even the research enterprise. Others are the result of conceptual disagreements about the importance and application of traditional research ethics norms to ‘comparative effectiveness research’ and modern research environments. Common among these explanations, however, is a failure to appreciate when a research intervention, rather than merely an observation or review of data, is taking place. Review committees and investigators are failing to see, or choosing to ignore, interventions in the lives of research subjects. When these studies have come to light, government agencies with oversight authority have done little or backed down. Prestigious medical journals have published research results knowing that the required consent was not obtained, or they have stood by the published studies even after the inadequacy of consent is discovered. This article critically examines this erosion of consent in theory and practice and calls for restoring the requirement of informed consent to its proper place as a priority in human subjects research. (shrink)