The sex‐determining genes of fungi reside at one or two specialised regions of the chromosome known as the mating type (MAT) loci. The genes are sufficient to determine haploid cell identity, enable compatible mating partners to attract each other, and prepare cells for sexual reproduction after fertilisation. How conserved are these genes in different fungal groups? New work1 seeks an answer to this question by identifying the sex‐determining regions of an early diverged fungus. These regions bear remarkable similarity to those (...) described in other fungi, but the sex proteins they encode belong to only a single class of transcription factor, the high mobility group (HMG), indicating that these are likely to be ancestral to other proteins recruited for fungal sex. BioEssays 30:711–714, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Although fair trade has grown exponentially in the U.S. in recent years, we do not have a clear understanding of why small U.S. firms choose to participate in it. To answer this question, we use a qualitative case study approach and grounded theory analysis to explore the motivations of 35 small fair trade businesses. We find that shared values and the desire to help others, often triggered by a critical incident, lead social entrepreneurs to found and sustain fair trade businesses. (...) The relationship between shared values and engagement in fair trade and the relationship between altruism and engagement in fair trade are strengthened by four motivating factors: direct relationships with producers, support for social causes, the desire for the preservation of craftsmanship, and the desire to share aesthetic products. These links are strengthened by four facilitating factors : the acquisition of business knowledge, family member involvement in the firm, assistance from faith communities, and assistance from the fair trade community. Additional analysis reveals three types of fair trade social entrepreneurs: “ethics first” entrepreneurs, primarily motivated by human rights and social justice concerns; “faith first” fair traders, motivated primarily by their religious faith; and “business first” businesspeople, motivated by what they perceive to be an opportunity to build a successful business while simultaneously doing “good” and helping others. (shrink)

Some commentators have recently proposed that “clinical equipoise,” although widely accepted, is not necessary for morally acceptable research on human subjects. If this concept is rejected, however, we may find that trials not in the best medical interests of their subjects—”bad deal trials”—could be justified. To avoid exploiting participants, we must find a way to distribute the risks fairly, even if it means embracing radical changes in the way clinical research is conducted.

Background: The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Discussion: Some researchers suggest that a closer examination of how socio-political structures influence healthcare (...) delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. Conclusion: We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by—and influence—the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. (shrink)

Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)

Rational expectations models have become a staple of economic theory and the basis for a Nobel Prize. This article argues that rational expectations analysis suffers from potentially fatal flaws that seriously undermine its value in understanding many market phenomena. Using the example of financial markets, the article illustrates how the rational expectations approach has worked to obscure, rather than to illuminate, our understanding of speculation and speculative markets. This misguidance raises problems for law and policy.

The term “exploitation” has gained wide currency in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer’s path-breaking work on the topic (Wertheimer 1999, 2011). Wertheimer presented a clear and compelling non-Marxist account of the concept of exploitation—one that stressed the connection between exploitation and unfair distributive outcomes. On this account, when one party exploits another, she takes advantage of the other to gain unfairly. A number of contemporary bioethicists (...) have accepted Wertheimer’s account of exploitation and have proceeded to apply it to a range of issues in research ethics (Hawkins and Emanuel 2008; Miller and Brody .. (shrink)

The use of case-based reasoning in teaching professional ethics has come of age. The fields of medicine, engineering, and business all have incorporated ethics case studies into leading textbooks and journal articles, as well as undergraduate and graduate professional ethics courses. The most recent guidelines from the National Institutes of Health recognize case studies and face-to-face discussion as best practices to be included in training programs for the Responsible Conduct of Research. While there is a general consensus that case studies (...) play a central role in the teaching of professional ethics, there is still much to be learned regarding how professionals learn ethics using case-based reasoning. Cases take many forms, and there are a variety of ways to write them and use them in teaching. This paper reports the results of a study designed to investigate one of the issues in teaching case-based ethics: the role of one’s professional knowledge in learning methods of moral reasoning. Using a novel assessment instrument, we compared case studies written and analyzed by three groups of students whom we classified as: Experts in a research domain in bioengineering. Novices in a research domain in bioengineering. The non-research group—students using an engineering domain in which they were interested but had no in-depth knowledge. This study demonstrates that a student’s level of understanding of a professional knowledge domain plays a significant role in learning moral reasoning skills. (shrink)

The common variety of incandescent light bulb has been in use for over a century, and although perhaps manufactured by highly technological systems, it is not a "high tech" device. Light bulbs are also found in nearly every home and business in this country. Because of these characteristics, the light bulb lends itself to use as a symbol of material things in modem industrial culture.

There is a lack of published evidence which demonstrates the impacts of public engagement in science and technology policy. This might represent the failure of PE to achieve policy impacts or indicate a lack of effective procedures for discerning the uptake by policy makers of PE-derived outputs. While efforts have been made to identify and categorize different types of policy impact, research has rarely attempted to link policy impact with PE procedures, political procedures, or the connections between them. In this (...) article, we propose a simple conceptual model to capture this information, based on semistructured interviews with both policy makers and PE practitioners. A range of criteria are identified to increase the policy impact of PE. The role of PE practitioners in realizing impacts through their interactions with policy makers in the informal “in-between” spaces of public engagement is emphasized. However, the potential contradictions between the pursuit of policy impacts and the more traditional conceptualizations of PE effectiveness are discussed. The main barrier to the identification of policy impacts from PE may lie within policy processes themselves. Political institutions have responsibility to establish formalized procedures for monitoring the uptake and use of evidence from PE in their decision-making processes. (shrink)

Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will (...) fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. (shrink)

This study provides empirical evidence in relation to a growing body of literature concerned with the ‘socialisation’ effects of accounting and business education. A prevalent criticism within this literature is that accounting and business education in the United Kingdom and the United States, by assuming a ‘value-neutral’ appearance, ignores the implicit ethical and moral assumptions by which it is underpinned. In particular, it has been noted that accounting and business education tends to prioritise the interests of shareholders above all other (...) stakeholder groups. This paper reports on the results of a set of focus group interviews with both undergraduate accounting students and students commencing their training with a professional accounting body. The research explores their perceptions about the purpose of accounting and the objectives of business. The findings suggest that both university and professional students' views on these issues tend to be informed by an Anglo-American shareholder discourse, whereby the needs of shareholders are prioritised. Moreover, this shareholder orientation appeared to be more pronounced for professional accounting students. (shrink)

The primary purpose of this study was to examine the effects of perceptions of product harm and consumer vulnerability on ethical evaluations of target marketing strategies. We first established whether subjects are able to accurately judge the harmfulness of a product through labeling alone, and whether they could differentiate consumers who were more or less vulnerable. The results suggest that without the presence of a prime, subjects who depended on implicit memory or guess were able to detect differences in “sin” (...) and “non-sin” products and consumer vulnerability, but were far less likely to be able to distinguish among high and low levels of product harm and consumer vulnerability. The inability to accurately identify high and low levels of product harm and consumer vulnerability impacted their perceptions of the ethicality of target marketing strategies, such that only four out of 18 target marketing strategies were judged as unethical. Thus, our findings contradict previous research that found subjects judged many more of the integrated strategies as unethical [Smith and Cooper- Martin, J Market 61 1]. Our results suggest that assessing ethical evaluations of strategies varying in product harm, and consumer vulnerability may only be relevant if consumers can accurately identify product harm. (shrink)

The allocation of vaccines and therapeutics for Covid‐19 obviously raises ethical questions, and physicians and ethicists have begun to address them. Writers have identified various criteria that should guide allocation decisions, but the criteria often conflict and need to be balanced against one another. This article proposes a model for thinking about how different considerations that are relevant to the distribution of vaccines and scarce treatments for Covid‐19 could be integrated into an allocation procedure. The model employs the construct of (...) a weighted lottery, which is a construct that has been employed in other contexts that involve the distribution of scarce resources. The article highlights the advantages of applying a weighted lottery to the Covid‐19 context and offers an illustration for how it might work in practice. The primary aim of the article is to articulate the structural features of a weighted lottery for this context and to bring out its advantages over other methods for allocating Covid‐19 medications. (shrink)

Death in the Clinic fills a gap in contemporary medical education by explicitly addressing the concrete clinical realities about death with which practitioners, patients, and their families continue to wrestle. Visit our website for sample chapters!

The topic of critical thinking has engaged philosophers, psychologists and educators for well over one hundred years. Amid polarized political attacks on the teaching of controversial issues, however, education in critical thinking appears to be nearing a new low, not only in the United States, but also in other countries being torn by partisan politics. This article reviews the ebb and flow of critical thinking efforts, suggests explanations for their discouraging results, and proposes a way forward that treats critical thinking (...) as an integrative process advanced by Mary Parker Follet, and more recently espoused by Bruno Latour and Donna Haraway. In the exploratory spirit of John Dewey and Alfred North Whitehead, I am introducing this essay, not with analysis or theory, but with a narrative of educational events in all their richness of context. These events describe how middle school students addressed the question of whether wolves should be removed from the endangered species list in the Northern Rocky Mountains of the United States. In the course of this discussion, I wish to demonstrate that thinking critically requires moving beyond winning, losing, or compromising to resolution of conflict, and furthermore, understanding that even stable resolutions must be revisited as events change. (shrink)

Background The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. Main body This article discusses some of the ethical challenges that were encountered in these research projects. Among (...) these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. Conclusion It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa. (shrink)

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related issues (...) as racism, sexuality, motherhood and abortion. (shrink)

Advances in machine learning hold promise for corpus analysis: they have the potential to allow for more efficient and less biased analyses of text. This would be a boon for qualitative research, such as the survey research conducted by Academic Philosophy Data and Analysis. In this paper we examine the utility of automated machine learning for select survey questions, with a focus on LDA and VADER. We thus compare human and machine coding on the question of whether underrepresented philosophers are (...) more likely to respond negatively to questions concerning diversity and inclusivity in academic philosophy. Our study has mixed results, revealing instances where automated machine learning can be used to fruitfully support and interrogate more traditional hand-coding techniques, but also instances where we were unable to glean much insight. (Contact authors for draft.). (shrink)

Drawing the line on physician assistance in physician-assisted death (PAD) continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill (...) that can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

Moral distress is prevalent within the neonatal intensive care unit (NICU) and can negatively affect clinicians. Studies have evaluated the causes of moral distress and interventions to mitigate it...

: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, (...) it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. (shrink)

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?

Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' (...) clinical care, while simultaneously acknowledging the generalised research aims. To illustrate the concept of therapeutic appropriation, we draw on data from an interview study which we conducted to investigate the experiences of patients and general practitioners involved in clinical trials in primary care. We argue that therapeutic appropriation has two key elements: comprehension that the research project is not necessarily aiming to benefit participants and the deliberate use of incidental features of the research for personal therapeutic benefit of various kinds. We conclude that therapeutic appropriation is a useful concept that refines understanding of potential ethical problems in clinical research, and points to strategies to address them. (shrink)

Raven10 years in Mexico. The mean IQs in relation to a British mean of 100 obtained from the 1979 British standardization sample and adjusted for the estimated subsequent increase were: 98·0 for whites, 94·3 for Mestizos and 83·3 for Native Mexican Indians.

In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)

This investigation was designed to evaluate a new dream content measure, the Casto Spirituality Scoring System. Therefore, our research question was: "Can the spiritual content of dream reports be identified and measured?" We randomly selected 20 male and 20 female dream reports obtained in dream seminars in each of six countries. We added 20 dream reports from one U.S. female and one U.S. male undergoing "spiritual development" programs. Of the 280 dream reports in our collection, 59 contained spiritual content, according (...) to our definition of "spiritual" as one's focus on, and/or reverence, openness, and connectedness to something of significance believed to be beyond one's full understanding and/or individual existence. The research question was answered affirmatively in so far as the Casto Spirituality Scoring System yielded high reliability when the scores of two judges, working independently, were compared. These initial results are promising but further research needs to be done before the usefulness of this system can be fully demonstrated. Key words: dreams, spirituality, consciousness, survey. (shrink)

As interest in working memory is increasing at a rapid pace, an open discussion of the central issues involved is both useful and timely. This new volume compares and contrasts conceptions of working memory, with contributions from proponents of different views.

ABSTRACT When applying moral principles to concrete cases, we assume a background shared understanding of the boundaries of the persons to whom the principles apply. In most contexts, this assumption is unproblematic. However, in end‐of‐life contexts, when patients are receiving ‘artificial’ life‐support, judgments about where a person's self begins and ends can become controversial. To illustrate this possibility, this paper presents a case in which a decision must be made whether to deactivate a patient's pacemaker as a means to hasten (...) his death. After discussing some common moral principles that are often applied to resolve ethical problems at the end of life and after explaining why they are of no help here, the paper argues that the correct analysis of this case, and of cases of this sort, turns on considerations that relate to the constitution of the self. These considerations, the paper further argues, sometimes resist resolution. The constitution of the self is fixed in large measure by our concepts and social conventions, and these do not always provide determinate grounds for delimiting the boundaries of the self. (shrink)

In this work, we evaluate the status of both theory and empirical evidence in the field of experimental rest-break research based on a framework that combines mental-chronometry and psychometric-measurement theory. To this end, we provide a taxonomy of rest breaks according to which empirical studies can be classified. Then, we evaluate the theorizing in both the basic and applied fields of research and explain how popular concepts relate to each other in contemporary theoretical debates. Here, we highlight differences between all (...) these models in the light of two symbolic categories, termed the resource-based and satiation-based model, including aspects related to the dynamics and the control mechanisms at work. Based on a critical assessment of existing methodological and theoretical approaches, we finally provide a set of guidelines for both theory building and future empirical approaches to the experimental study of rest breaks. We conclude that a psychometrically advanced and theoretically focused research of rest and recovery has the potential to finally provide a sound scientific basis to eventually mitigate the adverse effects of ever increasing task demands on performance and well-being in a multitasking world at work and leisure. (shrink)

Ethical research on human subjects requires that subjects, if they have the capacity to do so, give free and informed consent to participate in the trials in which they are enrolled. This requirement, which is commonly referred to as the principle of informed consent, was prominently endorsed by the authors of the Belmont Report in 1978, and it remains widely accepted today. Yet while the principle of informed consent is by now almost universally accepted, the responsibilities that it imposes on (...) those who conduct research on human subjects is a more contentious matter. New challenges to securing informed consent have emerged since the publication of the Belmont Report, and responding to these challenges requires... (shrink)

One cue that may facilitate children's word learning is iconicity, or the correspondence between a word's form and meaning. Some have even proposed that iconicity in the early lexicon may serve to help children learn how to learn words, supporting the acquisition of even noniconic, or arbitrary, word–referent associations. However, this proposal remains untested. Here, we investigate the iconicity of caregivers’ speech to young children during a naturalistic free‐play session with novel stimuli and ask whether the iconicity of caregivers’ speech (...) facilitates children's learning of the noniconic novel names of those stimuli. Thirty‐four 1.5‐2‐year‐olds (19 girls; half monolingual English learners and half bilingual English‐Spanish learners) participated in a naturalistic free‐play task with their caregivers followed by a test of word‐referent retention. We found that caregivers’ use of iconicity, particularly in utterances in which they named the novel stimuli, was associated with the likelihood that children learned that novel name. This result held even when controlling for other factors associated with word learning, such as the concreteness and frequency of words in caregiver speech. Together, the results demonstrate that iconicity not only can serve to help children identify the referent of novel words (as in previous research) but can also support their ability to retain even noniconic word‐referent mappings. (shrink)

Moral distress is a phenomenon that has been receiving increasing attention in nursing and other health care disciplines. Moral distress is a concept that entered the nursing literature – and subsequently the health care ethics lexicon – in 1984 as a result of the work done by American philosopher and bioethicist Andrew Jameton. Over the past decade, research into moral distress has extended beyond the profession of nursing as other health care disciplines have come to question the impact of moral (...) constraint on individual practitioners, professional practice, and patient outcomes. Along with increased interest in the phenomenon of moral distress have come increasing critiques – critiques that in their essence point to a serious lack of conceptual clarity in the definition, study, and application of the concept. Foundational to gaining conceptual clarity in moral distress in order to develop strategies to prevent and ameliorate the experience is a careful revisiting of the epistemological assumptions underpinning our knowledge and use of the concept of moral distress. It is our contention that the conceptual challenges reveal flaws in the original understanding of moral distress that are based on an epistemological stance that holds a linear conception of cause and effect coupled with a simplistic perspective of ‘constraint’ and ‘agency’. We need a more nuanced approach to our study of moral distress such that our ontological and epistemological stances help us to better appreciate the complexity of moral agents acting in organizational contexts. We believe that critical realism offers such a nuanced approach. (shrink)

A corporate culture strengthened by ethical values and other positive business practices likely yields more favorable employee work responses. Thus, the purpose of this study was to assess the degree to which perceived corporate ethical values work in concert with group creativity to influence both job satisfaction and turnover intention. Using a self-report questionnaire, information was collected from 781 healthcare and administrative employees working at a multi-campus education-based healthcare organization. Additional survey data was collected from a comparative convenience sample of (...) 127 sales and marketing employees working for a variety of firms operating in the south-central United States. The results indicated that group creativity and corporate ethical values were positively related, and that both variables were associated with increased job satisfaction. Conversely, corporate ethical values and job satisfaction were associated with decreased turnover intention. Sales managers should create work cultures that precipitate increased ethical values and group creativity, and suggestions about how they may institutionalize these factors are provided. (shrink)

The burgeoning interest in arts-informed research and the increasing variety of visual possibilities as a result of new technologies have paved the way for researchers to explore and use visual forms of inquiry. This article investigates how collage making and concept mapping are useful visual approaches that can inform qualitative research. They are experiential ways of doing/knowing that help to get at tacit aspects of both understanding and process and to make these more explicit to the researcher and more accessible (...) to audiences. It outlines specific ways that each approach can be used with examples to illustrate how the approach informs the researcher's experience and that of the audience. The two approaches are compared and contrasted and issues that can arise in the work are discussed. (shrink)

In recent years, a number of writers have proposed voluntary stopping of eating and drinking as an alternative to physician-assisted suicide. This paper calls attention to and discusses some of the ethical complications that surround the practice of voluntary stopping of eating and drinking. The paper argues that voluntary stopping of eating and drinking raises very difficult ethical questions. These questions center on the moral responsibility of clinicians who care for the terminally ill as well as the nature and limits (...) of the authority they exercise over them. (shrink)

Informed consent is a central concept in the literature on the ethics of clinical care and human subjects research. There is a broad consensus that ethical practice in these domains requires the informed consent of patients and subjects. The requirements of informed consent in these domains, however, are matters of considerable controversy. Some argue that the requirements of informed consent have been inflated, others that they have not been taken seriously enough. This essay argues that both sides are partly right. (...) To advance this argument, the essay distinguishes a general doctrine of informed consent from what it characterizes as “models of informed consent.” A general doctrine articulates a set of requirements for informed consent and then adjusts these requirements to fit the context in which they are to be applied. In contrast, different models of informed consent impose different requirements in different contexts. The essay contends that different models of informed consent are needed for clinical care and clinical research. It outlines these two models, articulates the rationale for distinguishing them, and considers and rebuts the objection that clinical care and clinical research are too deeply intertwined in contemporary medicine for the models approach to apply to them. (shrink)

I consider an alleged example of a non-transitive causal chain, on the basis of which J. Lee has argued that causation is non-transitive. I show that his analysis of the example rests on too coarse-grained an approach to causal relata. I develop a fine-grained analysis of events which owes much to Dretske’s notion of an allomorphic event, and I use this analysis to show that in the example all the genuine causal chains are indeed transitive. It emerges that when fine-grained (...) analyses of events are possible, causal contexts are aIlomorphicaIly sensitive. (shrink)