Background: Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. Methods: This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (...) (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Results: Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). Conclusions: AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials. (shrink)

People’s comfort with and acceptability of artificial intelligence (AI) instantiations is a topic that has received little systematic study. This is surprising given the topic’s relevance to the design, deployment and even regulation of AI systems. To help fill in our knowledge base, we conducted mixed-methods analysis based on a survey of a representative sample of the US population (_N_ = 2254). Results show that there are two distinct social dimensions to comfort with AI: as a peer and as a (...) superior. For both dimensions, general and technological efficacy traits—locus of control, communication apprehension, robot phobia, and perceived technology competence—are strongly associated with acceptance of AI in various roles. Female and older respondents also were less comfortable with the idea of AI agents in various roles. A qualitative analysis of comments collected from respondents complemented our statistical approach. We conclude by exploring the implications of our research for AI acceptability in society. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

In this article, we investigate how the concept of Care Biography and related concepts are understood and operationalised and describe how it can be applied to advancing our understanding and practice of holistic and person‐centred care. Walker and Avant's eight‐step concept analysis method was conducted involving multiple database searches, with potential or actual applications of Care Biography identified based on multiple discussions among all authors. Our findings demonstrate Care Biography to be a novel overarching concept derived from the conjunction of (...) multiple other concepts and applicable across multiple care settings. Concepts related to Care Biography exist but were more narrowly defined and mainly applied in intensive care, aged care, and palliative care settings. They are associated with the themes of Meaningfulness and Existential Coping, Empathy and Understanding, Promoting Positive Relationships, Social and Cultural Contexts, and Self‐Care, which we used to inform and refine our concept analysis of Care Biography. In Conclusion, the concept of Care Biography, can provide a deeper understanding of a person and their care needs, facilitate integrated and personalised care, empower people to be in control of their care throughout their life, and help promote ethical standards of care. (shrink)

Whilst previous observational studies have linked negative thought processes such as an external locus of control and holding negative cognitive styles with depression, the directionality of these associations and the potential role that these factors play in the transition to adulthood and parenthood has not yet been investigated. This study examined the association between locus of control and negative cognitive styles in adolescence and probable depression in young adulthood and whether parenthood moderated these associations. Using a UK prospective population-based birth (...) cohort study: the Avon Longitudinal Study of Parents and Children, we examined the association between external locus of control and negative cognitive styles in adolescence with odds of depression in 4,301 young adults using logistic regression models unadjusted and adjusted for potential confounding factors. Interaction terms were employed to examine whether parenthood moderated these associations. Over 20% of young adults in our sample were at or above the clinical threshold indicating probable depression. For each standard deviation increase in external locus of control in adolescence, there was a 19% higher odds of having probable depression in young adulthood, after adjusting for various confounding factors including baseline mood and different demographic and life events variables. Similarly, for each SD increase in negative cognitive styles in adolescence, there was a 29% higher odds of having probable depression in the adjusted model. We found little evidence that parenthood status moderated the relationship between external locus of control or negative cognitive styles in adolescence and probable depression following adjustment for confounding factors. Effect estimates were comparable when performed in the complete case dataset. These findings suggest that having an external locus of control and holding negative cognitive styles in mid- to late adolescence is associated with an increased likelihood of probable depression in young adulthood. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

Just Words: On Speech and Hidden Harm, by McGowanMary Kate. Oxford: Oxford University Press, 2019. Pp. xi + 209.

I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)

However widely--and differently--Jacques Derrida may be viewed as a "foundational" French thinker, the most basic questions concerning his work still remain unanswered: Is Derrida a friend of reason, or philosophy, or rather the most radical of skeptics? Are language-related themes--writing, semiosis--his central concern, or does he really write about something else? And does his thought form a system of its own, or does it primarily consist of commentaries on individual texts? This book seeks to address these questions by returning to (...) what it claims is essential history: the development of Derrida's core thought through his engagement with Husserlian phenomenology. Joshua Kates recasts what has come to be known as the Derrida/Husserl debate, by approaching Derrida's thought historically, through its development. Based on this developmental work, Essential History culminates by offering discrete interpretations of Derrida's two book-length 1967 texts, interpretations that elucidate the until now largely opaque relation of Derrida's interest in language to his focus on philosophical concerns. A fundamental reinterpretation of Derrida's project and the works for which he is best known, Kates's study fashions a new manner of working with the French thinker that respects the radical singularity of his thought as well as the often different aims of those he reads. Such a view is in fact "essential" if Derrida studies are to remain a vital field of scholarly inquiry, and if the humanities, more generally, are to have access to a replenishing source of living theoretical concerns. (shrink)

This article examines the “Choice Argument” for sweatshops, i.e., the claim that it is morally wrong or impermissible for third parties to interfere with the choice of sweatshop workers to work in sweatshops. The Choice Argument seeks, in other words, to shift the burden of proof onto those who wish to regulate sweatshop labor. It does so by forcing critics of sweatshops to specify the conditions under which it is morally permissible to interfere with sweatshop workers’ choice. My aim in (...) this article is to meet that burden. Unlike other critics of sweatshop labor, however, my argument does not proceed from contested economic or moral assumptions. To the contrary, my strategy will be to demonstrate that even if we grant the truth of the economic and moral assumptions made by defenders of the Choice Argument, it never- theless does not follow that it is morally wrong to interfere with the choice of sweatshop workers to work in sweatshops. The Choice Argument thus fails on its own terms. (shrink)

Calling into question all structural rules and principles relating to language, Joshua Kates presents a radical new path for interpreting this every day, taken-for-granted tool of communication. Traversing theory, literary criticism, philosophy, and the philosophy of language, the book speaks to contemporary debates on analytical and humanistic modes of inquiry. Language and texts are thought of as active 'events', replete with allusions to history, context and tradition that are always in the making. This emphasis makes the case for a (...) rigorous inquiry of text and talk in all their forms, bridging the continental and analytical divide in the process. (shrink)

Despite substantial evidence pointing to a looming Malthusian catastrophe, governmental measures to reduce population have been opposed both by religious conservatives and by many liberals, especially liberal feminists. Liberal critics have claimed that 'utilitarian' population policies violate a 'fundamental right of reproductive liberty'. This essay argues that reproductive liberty should not be considered a fundamental human right, or certainly not an indefeasible right. It should, instead, be strictly regulated by a global agreement designed to reduce population to a sustainable level. (...) Three major points are discussed: 1) the current state of the overpopulation problem; 2) the claim of a fundamental human right of reproductive liberty; 3) an outline of a global agreement to address overpopulation as a 'tragedy of the commons'. (shrink)

The article is an explication of husserl's theory of perception. In particular, The meaning of 'constitution' is analyzed, With the result that traditional realistic or idealistic readings of husserl are discarded. Examination of passive and active synthesis and the meaning of 'hyle' within the framework of husserl's theory of inner time-Consciousness clarifies in turn the nature of phenomenological intuition and the significance of reduction.

This article explores what it calls the “documentarist” hypothesis: the belief that the subject matter of history, the past, is structurally absent and thus can be reached only by way of documents, testamentary traces of various sorts . The first part of the article works out the documentarist position through interpretations of creative works that embody it and of a variety of reflections on historiography—those of Michel de Certeau and Paul Ricoeur, as well as some “postmodern historiography.” It argues that (...) documentarism ultimately faces an insoluble problem: it presupposes the pastness of the past, yet it cannot give itself the latter by way of the documents to which it believes itself confined. Documentarism assumes as already at hand a historical-temporal horizon of past, present, and future, for which it itself cannot account. In the second part of the article, accordingly, I turn to the historiographical portion of Faulkner's The Bear to expose the operativity of this always already given temporality. Faulkner's tale gives us access to a more radical historicity than any upon which documentarists reckon; yet this historicity turns out to sit askew from the usual frameworks of history as we know them, especially those of periods and epochs. The tension in Faulkner's own work between periodizing and event-laden explanations, I conclude, points to questions that fall beyond history as currently conceived. (shrink)

There is a lot to like in Neal DeRoo’s Futurityin Phenomenology. In it, he canvases his three titular authors’ treatments of time , and his scholarship on all three is impressive. He shows himself familiar with their most decisive texts on this subject, as well as with much of the relevant secondary literature. His treatment of Husserl is especially noteworthy. DeRoo’s treatment of this subject, which in part draws on his previous publications, equals, if not surpasses, especially in its scope (...) and detail, all others in English that bring Husserl’s work on time together with French “post-Husserlians,” such as Emmanuel Levinas and Jacques Derrida.Along with generally sound presentations of difficult texts, DeRoo also often wrestles admirably with the things themselves. On a number of occasions, having seemingly completed an argument or arrived at a conclusion, he turns around and calls it into question. (Thus, having associated futurity with ethicality, he repeated .. (shrink)

The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

In 2006, I was diagnosed with cancer. This began a crash course in real-world medical ethics. Having cancer was awful, but it was instructive, too. The experience gave me a new understanding of what my profession is about. Individuals in the bioethics field often address topics related to cancer, such as medical decision-making, the patient-physician relationship, clinical trials, and access to health care. Yet few engaged in this work have lived with cancer themselves. Experience as a cancer patient or family (...) caregiver extends and deepens one’s thinking about serious illness and bioethics. During my time as a cancer patient, I kept in touch with several colleagues immersed in their own cancer .. (shrink)

Kuyumcuoglu argues that defenders of sweatshop regulations should reject consequentialism and accept an ex ante interpretation of contractualism instead. In this Commentary I show that Kuyumcuoglu’s argument doesn’t succeed. Defenders of sweatshops shouldn’t become ex ante contractualists because its advantages on this issue are more apparent than real.

It is unclear whether someone’s responsibility for developing a disease or maintaining his or her health should affect what healthcare he or she receives. While this dispute continues, we suggest that, if responsibility is to play a role in healthcare, the concept must be rethought in order to reflect the sense in which many health-related behaviours occur repeatedly over time and are the product of more than one agent. Most philosophical accounts of responsibility are synchronic and individualistic; we indicate here (...) what paying more attention to the diachronic and dyadic aspects of responsibility might involve and what implications this could have for assessments of responsibility for health-related behaviour. (shrink)

Three types of objections have been raised against sweatshops. According to their critics, sweatshops are (1) exploitative, (2) coercive, and (3) harmful to workers. In “The Ethical and Economic Case Against Sweatshop Labor: A Critical Assessment,” Powell and Zwolinski critique all three objections and thereby offer what is arguably the most powerful defense of sweatshops in the philosophical literature to date. This article demonstrates that, whether or not unregulated sweatshops are exploitative or coercive, they are, pace Powell and Zwolinski, harmful (...) to workers. (shrink)

This article reads the uptake of facial-matching algorithms by fertility clinics in Spain through the lens of ‘the fertility fix’: a software fix to the social reconfiguration of kinship and a fixed capital investment made by competing fertility companies and firms. ‘The fertility fix’ is proposed as a critical, ethical lens through which to situate algorithmic facial-matching in assisted reproduction in the context of the racial politics of the face and phenotype and the spatial politics of market expansion. While an (...) ‘infertility crisis’ is often mentioned when explaining the growth of the assisted reproductive technologies (ARTs) industry, the use of donated reproductive cells is tied up in societal, ecological and economic shifts. Combining Software Studies analysis with Marxist Feminist and trans*feminist perspectives on shifting re/production dynamics, the article details the role of computational technologies in promoting certain ideas and beliefs about family and fixing certain territories of capital flow. (shrink)

Mass Hysteria examines the medical and cultural practices surrounding pregnancy, new motherhood, and infant feeding. Late eighteenth century transformations in these practices reshaped mothers' bodies, and contemporary norms and routines of prenatal care and early motherhood have inherited the legacy of that era. As a result, mothers are socially positioned in ways that can make it difficult for them to establish and maintain healthy and safe boundaries and appropriate divisions between public and private space.

According to the nonworseness claim, it cannot be morallyworseto exploit someone than not to interact with them at all when the interaction 1) is mutually beneficial, 2) is voluntary, and 3) has no negative effects on third parties. My aim in this article is to defend the moral significance of exploitation from this challenge. To that end, I develop a novel account of why sweatshop owners have a moral obligation to pay sweatshop workers a nonexploitative wage despite the fact that (...) their relationship is entirely optional. More precisely, I defend two main claims. First, I show that sweatshop owners are morally obligated to pay sweatshop workers a nonexploitative wage even though they have a right not to hire them and even though that will require them to pay sweatshop workers a wage that is higher than the one they voluntarily accepted. Second, I explain why this obligation on the part of sweatshop owners is not defeated by the fact that other individuals not party to the transaction would benefit even more than sweatshop workers from receiving this additional level of pay. (shrink)

Ritchie Robertson, Richard Sher, and Alicia Montoya are three of the most distinguished scholars of eighteenth-century book history and the Enlightenment, and I cannot think of a triumvirate more q...

When Betty Friedan published The Feminine Mystique in 1963, the book exploded into women's consciousness. Before the decade was out, what had begun as a campaign for women's civil rights transformed into a diverse and revolutionary movement for freedom and social justice that challenged many aspects of everyday life long accepted as fixed: work, birth control and abortion, childcare and housework, gender, class, and race, art and literature, sexuality and identity, rape and domestic violence, sexual harassment, pornography, and more. This (...) was the women's liberation movement, and writing--powerful, personal, and prophetic--was its beating heart. Fifty years on, in the age of #MeToo and Black Lives Matter, this visionary and radical writing is as relevant and urgently needed as ever, ready to inspire a new generation of feminists. Activists and writers Alix Kates Shulman and Honor Moore have gathered an unprecedented collection of works--many long out-of-print and hard to find--that catalyzed and propelled the women's liberation movement. Ranging from Friedan's Feminine Mystique to Backlash, Susan Faludi's Reagan-era requiem, and framed by Shulman and Moore with an introduction and headnotes that provide historical and personal context, the anthology reveals the crucial role of Black feminists and other women of color in a decades long mass movement that not only brought about fundamental changes in American life--changes too often taken for granted today--but envisioned a thoroughgoing revolution in society and consciousness still to be achieved"--Back cover. (shrink)

Questions of what a self-driving car ought to do if it encounters a situation analogous to the ‘trolley problem’ have dominated recent discussion of the ethics of self-driving cars. This paper argues that this interest is misplaced. If a trolley-style dilemma situation actually occurs, given the limits on what information will be available to the car, the dynamics of braking and tyre traction determine that, irrespective of outcome, it is always least risky for the car to brake in a straight (...) line rather than swerve. (shrink)

The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has been (...) unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. (shrink)

This article argues that only a developmental approach-one that views Derrida's 1967 work on Husserl, La Voix et la phénomène, in light of Derrida's three earlier encounters with Husserl's work and recognizes significant differences among them-is able to resolve the bitter controversy that has lately surrounded Derrida's Husserl interpretation. After first reviewing the impasse reached in these debates, the need for "a new hermeneutics of deconstruction" is set out, and, then, the reasons why strong development has been rejected internal to (...) Derrida's corpus are discussed. After this, in a discussion of interest with respect to Husserl's own late teachings, as well as Derrida's standpoint, this article focuses on Derrida's 1962 "Introduction to Husserl's Origin." Against the prevailing interpretation, an argument is made showing that Derrida is much closer to Husserl's own positions than has been suspected, most importantly, in section VII of the "Introduction" where the theme of writing is first introduced. Thanks to this, that significant development in Derrida's thought does take place between 1962 and 1967 is demonstrated-and the present piece concludes by providing a brief sketch of the development of deconstruction overall as it came about through Derrida's repeated encounters with Husserlian phenomenology in the years 1954–67. (shrink)