BackgroundThe role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues.MethodsWe conducted seven (...) day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly.ResultsBroad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research.ConclusionBecause no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research. (shrink)

Participants of round table discussion : James David Barber ; Marilyn Berger ; Creed Black ; Louis Boccardi ; David Broder ; David Burgin ; John Chancellor ; Michael Gartner ; Don Hewitt ; Larry Jinks ; David Laventhol ; Barbara Matusow ; Jack Nelson ; Martin Nolan ; Eugene Patterson ; Ralph Renick ; Van Gordon Sauter ; Tony Schwartz ; John Seigenthaler ; Sander Vanocur ; Judy Woodruff ; Roy Peter Clark ; Don Fry ; Robert (...) Haiman. (shrink)

Anthropology of Consciousness, Volume 32, Issue 2, Page 129-153, Autumn 2021.

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items (...) of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability. (shrink)

The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the humanistic crisis in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physican may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These Three Stages of Medical Dialogue include:1. An Initial Personal Meeting stage, which initiates (...) the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or Healing Through Meeting Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed. (shrink)

Thomas W. Dunfee, in addition to his many other contributions to business ethics literature, has generated a stream of research that attempts to tackle the issue of corruption. Dunfee's research on corruption includes three primary contributions: the introduction of "Integrative Social Contract Theory" which provides a normative theoretical framework by which to judge the morality of global business activity including corruption; the "C2 Principles", which outline specific content and implementation measures that corporations can voluntarily adopt to combat corruption; and a (...) normative evaluation of "guanxi," a concept which can lead to questionable corruption practices in China. The article will highlight Dunfee's contribution to the literature and suggest future research directions based on his academic work. (shrink)

This paper attempts to build on the contribution to moral imagination theory by Patricia Werhane by further integrating moral imagination with new theoretical developments that have taken place in the business ethics field. To accomplish this objective, part one will review the concept of moral imagination, from its definitional origins to its full theoretical conceptualization. Part two will provide a brief literature review of how moral imagination has been applied in empirical research. Part three will analyze and apply the construct (...) of moral imagination as it relates to the key process stages of ethical decision making including awareness, judgment, intention, and behavior. Immoral imagination is then discussed, along with other behavioral ethics concepts as they relate to moral imagination. The paper concludes with potential future research directions, as well as teaching and managerial implications for the moral imagination construct. (shrink)

This paper discusses the individuation of characters for the use asunits by geneticists at the beginning of the 20th century. Thediscussion involves the Presence and Absence Hypothesis as a case study. It issuggested that the gap between conceptual consideration and etiological factorsof individuating of characters is being handled by way of mutual adjustment.Confrontation of a suggested morphological unit character with experimentresults molded the final boundaries of it.

The three notions of illocutionary force, sentence-meaning, and speaker-meaning (what a speaker means by an utterance) have been bandied about, misused and confused in some influential papers about speech acts and, I presume, in quieter corners as well. My object here is to disentangle these notions.

Genetic counseling is viewed as a therapeutic interrelationship between genetic counselors and their clients. In a previous relational ethics research project, various themes were identified as key components of relational ethics practice grounded in everyday health situations. In this article the relational ethics approach is further explored in the context of genetic counseling to enhance our understanding of how the counselor-client relationship is contextually developed and maintained. Qualitative interviews were conducted with six adult clients undergoing genetic counseling for predictive testing. (...) Engagement, dialogue and presence were revealed as relevant to genetic counselor-client relationships. A relational ethics approach in genetic counseling challenges the concept of nondirectiveness and may enhance the outcome of counseling for both counselor and client. (shrink)

Recent approaches towards an understanding of the molecular basis of X‐chromosome inactivation in mammals suggest that regulation is due to multiple events including DNA methylation.

Entre la première philosophie cavaillésienne de « l’expérience mathématique » et son réexamen au sein de l’œuvre posthume (Sur la logique et la théorie de la science), nous suggérons qu’il existe une différence radicale de statut, qui différencie de l’intérieur la philosophie du concept de celle de l’œuvre publiée. Le sens testamentaire du livre posthume comme sa conclusion hégélienne tiennent à cette différence. Le nouveau cadre construit pour la philosophie mathématique est celui d’un « Traité de logique », qui prend (...) la forme d’une histoire orientée par l’exigence de reconstruire le lien de la logique avec l’ontologie, alors que la première philosophie pouvait, à son niveau, sembler ignorer, ou même écarter cette exigence. Cette histoire de la logique n’annonce pas plus qu’elle n’offre la construction d’une dialectique identifiable à celle que Cavaillès avait d’abord reconnue dans la nécessité de l’expérience mathématique. Ses étapes, non chronologiquement ordonnées, sont celles de la préparation effective d’un passage de la conscience au concept en tant que principes de la doctrine de la science. Ce passage n’est pas un passage nécessité par la préexistence de contradictions à dépasser et la libre et créative réponse qu’elles demandent à la pensée humaine en mathématiques ; il est celui qui anime le libre choix de chercher, dans une Logique entendue comme théorie des formes de l’être, la liberté créatrice qui est définitoire de la pensée en tant que telle. (shrink)

Backdating of stock options is an example of an agency problem. It has emerged despite all the measures (i.e., new regulations and additional corporate governance mechanisms) aimed at addressing such problems? Beyond such negative controlling measures, a more positive empowering approach based on ethics may also be necessary. What ethical measures need to be taken to address the agency problem? What values and norms should guide the board of directors in protecting the shareholders' interests? To examine these issues, we first (...) discuss the role values and norms can play with respect to underlying corporate governance and the proper role of directors, such as transparency, accountability, integrity (which is reflected in proper mechanisms of checks and balances), and public responsibility. Second, we discuss various stakeholder approaches (e.g., government, directors, managers, and shareholders) by which conflicts of interest (i.e., the agency problem) can be addressed. Third, we assess the practice of backdating stock options, as an illustration of the agency problem, in terms of whether the practice is legally acceptable or ethically justifiable. Fourth, we proceed to an analysis of good corporate governance practice involving backdating options based on a series of ethical standards including: (1) trustworthiness; (2) utilitarianism; (3) justice; and (4) Kantianism. We conclude that while executive compensation schemes (e. g., stock options) were originally intended to help remedy the agency problem by tying together the interests of the executives and shareholders, these schemes may have actually become "part of the problem," and that the solution ultimately depends upon whether directors and executives accept that all of their actions must be based on a set of core ethical values. (shrink)

Private law theory must confront the plurality of values that inform the problems that private law addresses in practice. We consider Hanoch Dagan’s and Michael Heller’s The Choice Theory of Contracts as a case-study in the promise and perils that embracing plural values poses for private law theory. We begin by arguing that private law theory cannot ignore value pluralism and identify three approaches that theory might take to pluralism. We call these approaches capitulating to, leveraging, and embracing value pluralism. (...) We illustrate each approach and assess its strengths and weaknesses. Theories that capitulate to pluralism simultaneously limit their scope and hamper their persuasiveness even within their restricted domains. Theories that leverage pluralism limit their domains more dramatically still. And theories that embrace pluralism are difficult to operationalize in practice without abandoning their pluralist roots. We briefly illustrate the drawbacks of capitulating to and leveraging pluralism with examples from recent contract theory. We then take up theories that embrace pluralism in greater detail, by studying Dagan and Heller’s approach. We argue that Dagan and Heller do not solve the deep problems that operationalizing their embrace of pluralism inevitably engenders. (shrink)

Under shift, caused for example by eye movement, or by relative movement of the subject or object of perception, the cortical representation undergoes very large changes in “size” and “shape.” Space-variance of cortical representation rules out models that fundamentally require linear interpolation between shifted patterns (e.g., Edelman's model) or rigid shift of an invariant retinal stimulus corresponding to shift at the cortex (e.g., the shifter theory of van Essen). Recently, a computational solution of “quasi-shift” invariance for space-variant mappings has been (...) constructed (Bonmassar & Schwartz 1997a; 1997b). (shrink)

CRISPR/Cas9 is quickly becoming one of the most influential biotechnologies of the last five years. Clinical trials will soon be underway to test whether CRISPR/Cas9 can edit away the genetic mutations that cause sickle cell disease (SCD). This article will present the background of CRISPR/Cas9 gene editing and SCD, highlighting research that supports the application of CRISPR/Cas9 to SCD. While much has been written on why SCD is a good biological candidate for CRISPR/Cas9, less has been written on the ethical (...) implications of including SCD in CRISPR/Cas9 research. This article will argue that there is a strong case in favor of including SCD. Three benefits are achieving distributive justice in research, continuing to repair the negative relationship between patients with SCD and the health‐care system, and benefit‐sharing for those who do not directly participate in CRISPR/Cas9 research. Opponents will argue that SCD is a risky candidate, that researchers will not find willing participants, and that the burden of SCD is low. Of this set of arguments, the first gives pause. However, on balance, the case in favor of including SCD in CRISPR/Cas9 research is stronger than the case against. Ultimately, this article will show that the historic and sociopolitical injustices that impede progress in treating and curing SCD can be alleviated through biotechnology. (shrink)

Historians have noted that many 19th-century founders and members of psychic societies were clergy, or had fathers who were clergy, seeking evidence for the survivalist hypothesis. One such member, psychologist Gardner Murphy, was influenced in childhood both by the Episcopalian faith of his father and the Transcendentalism of his mother's hometown, Concord, Massachusetts. We propose that these religious and philosophical influences, as well as his childhood experiences informed his life's work. They also prompted Gardner Murphy to focus on the survivalist (...) hypothesis and commit to discovering a scientific approach that might yield evidence of paranormal phenomena. Murphy was highly respected for his biosocial theory of personality and his contributions to the discipline of psychology, even while he persisted in studying parapsychology, an area of contention in the relatively new science of psychology. He drew on the potential synergy of world religions and philosophical traditions as a means of understanding human behavior – in each case revealing him as the polymath and ethical humanist for which he is remembered. Like William James, he viewed reported psychic experiences as simply another human phenomenon to be examined using the scientific method. His ability to entwine these interests seems motivated by his religious upbringing and academic training in the sciences. (shrink)

Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively meeting the (...) needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. (shrink)