Technology has expanded genomic research and the complexity of extracted gene-related information. Health-related genomic incidental findings pose new dilemmas for nurse researchers regarding the ethical application of disclosure to participants. Consequently, informed consent specific to incidental findings is recommended. Critical Social Theory is used as a guide in recognition of the changing meaning of informed consent and to serve as a framework to inform nursing of the ethical application of disclosure consent in genomic nursing research practices.

BackgroundAn increasing number of studies utilize intracranial electrophysiology in human subjects to advance basic neuroscience knowledge. However, the use of neurosurgical patients as human research subjects raises important ethical considerations, particularly regarding informed consent and undue influence, as well as subjects’ motivations for participation. Yet a thorough empirical examination of these issues in a participant population has been lacking. The present study therefore aimed to empirically investigate ethical concerns regarding informed consent and voluntariness in Parkinson’s disease patients undergoing deep brain (...) stimulator (DBS) placement who participated in an intraoperative neuroscience study.MethodsTwo semi-structured 30-minute interviews were conducted preoperatively and postoperatively via telephone. Interviews assessed participants’ motivations for participation in the parent intraoperative study, recall of information presented during the informed consent process, and participants’ postoperative reflections on the research study.ResultsTwenty-two participants (mean age = 60.9) completed preoperative interviews at a mean of 7.8 days following informed consent and a mean of 5.2 days prior to DBS surgery. Twenty participants completed postoperative interviews at a mean of 5 weeks following surgery. All participants cited altruism or advancing medical science as “very important” or “important” in their decision to participate in the study. Only 22.7% (n = 5) correctly recalled one of the two risks of the study. Correct recall of other aspects of the informed consent was poor (36.4% for study purpose; 50.0% for study protocol; 36.4% for study benefits). All correctly understood that the study would not confer a direct therapeutic benefit to them.ConclusionEven though research coordinators were properly trained and the informed consent was administered according to protocol, participants demonstrated poor retention of study information. While intraoperative studies that aim to advance neuroscience knowledge represent a unique opportunity to gain fundamental scientific knowledge, improved standards for the informed consent process can help facilitate their ethical implementation. (shrink)

Confidentiality is one of the foundations on which psychotherapy is built. Limitations on confidentiality in the therapeutic process have been explained and explored by many authors and organizations. However, controversy and confusion continue to exist with regard to the limitations on confidentiality in situations where clients are considering their options at the end of life and after a client has died. This article reviews these 2 areas and provides some suggestions for future research.

Much neuroethics literature concludes with a set of normative recommendations. While these recommendations can be a helpful way of summarizing a proposal for a future direction, some have recently argued that ethics scholarship has devoted insufficient attention to considerations of audience and real-world applications. To date, however, while scholars have conducted topic analyses of neuroethics literature, to our knowledge no study has evaluated who neuroethics scholarship addresses and what it recommends. The objective of the present study therefore was to provide (...) a preliminary characterization of recommendations offered in neuroethics scholarship and an assessment of their target audiences. Rather than attempting to demarcate what constitutes “neuroethics scholarship,” we analyzed text that authors’ had self-identified as being neuroethics-related: abstracts presented at the International Neuroethics Society (INS) annual meetings and published as top abstracts in AJOB Neuroscience in the last decade (2011–2020). We found that a majority of abstracts utilized conceptual methods (62.2%) and provided conceptual recommendations (68%). Roughly 77% of all abstracts did not explicitly address a target audience, yet nearly all of these were implicitly directed at other scholars. The remainder specified a target audience of scholars (12.2%), regulators (6.7%), healthcare providers (6.7%) and industry (2.6%). Only a subset of abstracts provided practical or policy recommendations (19.7%). Of those, the majority (61.5%) did not specify a target audience. Among the subset with actionable recommendations, a clarification of target audience may help increase the impact. (shrink)

Background In the early 2010s, a phenomenon known as do-it-yourself (DIY) fecal microbiota transplant (FMT) emerged as lay individuals began self-administering FMTs at home. Although prior research indicates that many individuals who perform DIY FMT have sought advice from healthcare providers, to date there has been no investigation of physicians’ experiences with DIY FMT. The objective of this qualitative study was to examine the attitudes of physicians who offer FMT regarding the practice of DIY FMT and to assess how they (...) navigated the ethical challenges of patient requests for DIY FMT.Methods We recruited physicians listed on two patient-created online databases of FMT providers. All physicians who indicated having been approached for advice about DIY FMT were included in the study. Semi-structured interviews with physicians explored their attitudes toward and experiences with DIY FMT.Results Of 18 physicians interviewed, one reported having provided counsel in response to an initial patient inquiry about DIY FMT, 2 indicated they explicitly advised against DIY FMT and refused to provide advice, and 15 fell in a middle category of discouraging DIY FMT and discussing reasons why. Among the physicians in this third category, four reported that they had changed their approach to providing counsel in response to a patient telling them they were going to perform DIY FMT anyway.Conclusions Physicians in our study employed a wide range of strategies for promoting safety in the DIY FMT context, from explicitly advising against the procedure to the provision of guidance aimed at mitigating potential harms. While there has been increasing attention to the practices of DIY medicine, this study underscores the need for greater attention to the ethically complex situations that physicians face when patients request guidance for unapproved at-home treatments. (shrink)

Governments must keep agricultural systems free of pests that threaten agricultural production and international trade. Biosecurity surveillance already makes use of a wide range of technologies, such as insect traps and lures, geographic information systems, and diagnostic biochemical tests. The rise of cheap and usable surveillance technologies such as remotely piloted aircraft systems presents value conflicts not addressed in international biosurveillance guidelines. The costs of keeping agriculture pest-free include privacy violations and reduced autonomy for farmers. We argue that physical and (...) digital privacy in the age of ubiquitous aerial and ground surveillance is a natural right to allow people to function freely on their land. Surveillance methods must be co-created and justified through using ethically defensible processes such as discourse theory, value-centred design and responsible innovation to forge a cooperative social contract between diverse stakeholders. We propose an ethical framework for biosurveillance activities that balances the collective benefits for food security with individual privacy: establish the boundaries of a biosurveillance social contract; justify surveillance operations for the farmers, researchers, industry, the public and regulators; give decision makers a reasonable measure of control over their personal and agricultural data; and choose surveillance methodologies that give the appropriate information. The benefits of incorporating an ethical framework for responsible biosurveillance innovation include increased participation and accumulated trust over time. Long term trust and cooperation will support food security, producing higher quality data overall and mitigating against anticipated information gaps that may emerge due to disrespecting landholder rights. (shrink)

The rubber hand paradigm is used to create the illusion of self-touch, by having the participant administer stimulation to a prosthetic hand while the Examiner, with an identical stimulus , administers stimulation to the participant’s hand. With synchronous stimulation, participants experience the compelling illusion that they are touching their own hand. In the current study, the robustness of this illusion was assessed using incongruent stimuli. The participant used the index finger of the right hand to administer stimulation to a prosthetic (...) hand while the Examiner used a paintbrush to administer stimulation to the participant’s left hand. The results indicate that this violation of tactile expectations does not diminish the illusion of self-touch. Participants experienced the illusion despite the use of incongruent stimuli, both when vision was precluded and when visual feedback provided clear evidence of the tactile mismatch. (shrink)

Objectives: To investigate the quality of consent gained for the use in research of tissue that is surplus after surgery. To compare the use of two consent forms: a simple locally introduced form and a more complex centrally instigated form. To discuss the attitudes of patients towards the use of their surplus tissue in research.Design: Data were collected through interviews and analysed with a combination of quantitative and qualitative analytical techniques.Participants and setting: Patients of the breast care unit at a (...) teaching hospital were interviewed at home or in a quiet room at the hospital.Results: 57 people were interviewed out of 81 approached, between October 2003 and March 2004. Most participants had a poor level of knowledge about the consent they had given, but reported being happy about having given it. The patients who had signed the locally introduced form had considerably more knowledge than those who had signed the centrally instigated form . Participants considered being well informed to be less important than believing that their opinions were valued and respected.Conclusions: The findings suggest that traditional models of informed consent are not universally applicable and, in this case, seem to overstate what people wish to know. The simple consent form achieved a better quality of informed consent and provided a better model of practice than the complex form, and it seemed that a focused approach to consent seeking is more effective and acceptable than more complex approaches. (shrink)

_ Source: _Volume 29, Issue 2, pp 129 - 147 Thomas Hobbes’s concept of felicity is a re-imagining of the Hellenistic concept of _eudaimonia_, which is based on the doctrine that people by nature are happy with little. His concept is based instead on an alternative view, that people by nature are never satisfied and it directly challenges the Aristotelian and Hellenistic concepts of _eudaimonia_. I also will suggest that Hobbes developed it from ideas he found in Aristotle’s _Rhetoric_ as (...) well as in Francis Bacon’s critique of ancient moral philosophy in _The Advancement of Learning_. (shrink)

Abstract.Growing interest in the origin of life, the physical foundations of biological theory, and the evolution of animal social systems has led to increasing efforts to understand the processes by which elements or living systems at one level of organizational complexity combine to form stable systems of higher order. J. Bronowski saw the need to extend or reformulate evolutionary theory to deal with the hierarchy problem and to account for the evolution of systems of “stratified stability.” The hierarchy problem has (...) become a matter of great interest also in nonequilibrium thermodynamic theory.An effort is made here to develop an abstract, phenomenological model, based on the laws of thermodynamics, to account for the origin and hierarchical evolution of living systems. It is argued that the principle of minimum entropy production, developed by I. Prigogine, applies generally to all thermodynamic systems and processes and is implicit in an extended and more complete formulation of the second law of thermodynamics. From this are derived a thermodynamic criterion and a principle of thermodynamic selection governing the formation of stable systems of “elements” of various levels of organization. Thermodynamic selection gives rise to the creation of “elements” having increasingly “open” characteristic structures which may combine spontaneously to form “social” or crystalline systems capable of growing and reproducing themselves through processes of fissioning or budding. Such simple, self‐reproducing systems are capable of evolving by natural selection, which is seen to be a special case of the more general process of thermodynamic selection. The principle of natural selection, thus formulated, has the character of a fundamental physical law. Self‐reproducing systems with suitably open hereditary programs may combine to form stable social systems, which may grow and reproduce as a unit. In this way self‐reproducing systems of increasing hierarchical order, size, and organizational complexity may evolve through processes of thermodynamic (natural) selection. Some implications of this open‐ended model and opportunities for testing its empirical and theoretical utility are explored. (shrink)

Social cognition is critical for successfully navigating social relationships. Current evidence suggests that older adults exhibit poorer performance in several core social-cognitive domains compared to younger adults. Neurocognitive decline is commonly discussed as one of the key arbiters of age-related decline in social-cognitive abilities. While evidence supports this notion, age effects are likely attributable to multiple factors. This paper aims to recontextualize past evidence by focusing issues of motivation, task design, and representative samples. In light of these issues, we identify (...) directions for future research to aide our understanding of social-cognitive aging. (shrink)

Rather than being inherently evil, business lobbying is a socially responsible activity which needs to be restrained by ethical standards. To be effective in a business environment, traditional ethical standards need to be translated into language which business persons can speak comfortably. Economical explanations must also be available to explain why ethical standards are appropriate in business. Eight such standards and their validating arguments are proposed with examples showing their use. Internal dialogues regarding the ethics of lobbying objectives and tactics (...) will plausibly occur only in businesses which recognize social responsibility mandates. Public interest stakeholders could hasten this recognition by making use of information made available by the Lobbying Disclosure Act of 1995 to institute external dialogues regarding lobbying by specific businesses and industry groups. Given practical ethical standards and the information on business lobbying provided by the law, the press, corporate activists, consumers, pension fund managers and the public can apply pressure for ethical lobbying practices. (shrink)

This study adds to the empirical evidence supporting a significant connection between ethics and profitability by examining the connection between published reports of unethical behaviour by publicly traded U.S. and multinational firms and the performance of their stock. Using reports of unethical behaviour published in the Wall Street Journal from 1989 to 1993, the analysis shows that the actual stock performance for those companies was lower than the expected market adjusted returns. Unethical conduct by firms which is discovered and publicized (...) does impact on the shareholders by lowering the value of their stock for an appreciable period of time. Whatever their views on whether ethical behaviour is profitable, managers should be able to see a definite connection between unethical behaviour and the worth of their firm's stock. Stockholders, the press and regulators should find this information important in pressing for greater corporate and managerial accountability. (shrink)

Cross cultural ethical conflicts are a major challenge for managers of multinational corporations (MNEs) when an MNE''s business practices and a host country''s practices differ. We develop a set of decision principles to help MNE managers deal with these conflicts and illustrate with examples of ethical conflicts faced by MNEs doing business in contemporary Russia (DeGeorge, 1994). We discuss the generalizability of the principles by comparing them to the Donaldson (1989) and Buller and Kohls (1997) decision models. Finally we discuss (...) changes in the cross cultural ethical problems facing MNE managers and offer suggestions for future corporate and academic work on these problems. (shrink)

Rather than being inherently evil, business lobbying is a socially responsible activity which needs to be restrained by ethical standards. To be effective in a business environment, traditional ethical standards need to be translated into language which business persons can speak comfortably. Economical explanations must also be available to explain why ethical standards are appropriate in business. Eight such standards and their validating arguments are proposed with examples showing their use. Internal dialogues regarding the ethics of lobbying objectives and tactics (...) will plausibly occur only in businesses which recognize social responsibility mandates. Public interest stakeholders could hasten this recognition by making use of information made available by the Lobbying Disclosure Act of 1995 to institute external dialogues regarding lobbying by specific businesses and industry groups. Given practical ethical standards and the information on business lobbying provided by the law, the press, corporate activists, consumers, pension fund managers and the public can apply pressure for ethical lobbying practices. (shrink)

The object of this article is to examine the letter from which Plutarch quotes in the above passage from the twenty-eighth chapter of his life of Alexander; to attempt to prove, particularly by a comparison of the letter with the Sidypafifia sent in 319 B.C. by Polyperchon to the Greek cities, that it is a genuine part of Alexander's correspondence; and further to consider what light the letter, if genuine, throws upon the person of Alexander himself.

Springer. We find in contemporary culture starkly contrasting estimates of the value of faith. On the one hand, for many people, faith is a virtue or positive human value, something associated with understanding, hope, and love, something to be inculcated, maintained, and cherished. On the other hand, for many people, faith is a vice, something associated with dogmatism, arrogance, and close-mindedness, something to be avoided at all costs. The papers included in this special (double) issue on approaches to faith explore (...) questions about faith in a variety of settings through a diverse range of examples, both secular and religious. The attempt to deepen our understanding of faith in the context of ordinary human relationships (e.g., between parents and children, friends, generals and their armies, business partners, citizens and the state), a commitment to ideals, or the pursuit of significant goals is clearly of general philosophical interest, as is the examination of potential connections between faith and topics such as trust or reliance. (shrink)

The importance of Pyrrhonism to Hobbes's political philosophy is much greater than has been recognized. He seems to have used Pyrrhonist arguments to support a doctrine of moral relativity, but he was not a sceptic in the Pyrrhonist sense. These arguments helped him to develop his teaching that there is no absolute good or evil; to minimise the purchase of natural law in the state of nature and its restrictions on the right of nature; virtually to collapse natural law into (...) civil law; and to make the sovereign the political, moral and theological epicenter of his political system. (shrink)

Available from UMI in association with The British Library. Requires signed TDF. ;It is the aim of this thesis to consider two accounts of 1st-person utterances that are often mistakenly conflated--viz. that involving the 'no-reference' view of 'I', and that of the non-assertoric thesis of avowals. The first account says that in a large range of 'psychological' uses, 'I' is not a referring expression; the second, that avowals of 1st-personal 'immediate' experience are primarily 'expressive' and not genuine assertions. ;The two (...) views are expressions of what I term 'Trojanism'. This viewpoint constitutes one side of a 'Homeric Opposition in the Metaphysics of Experience', and has been endorsed by Wittgenstein throughout his writings; it has received recent expression in Professor Anscombe's article 'The First Person'. I explore the ideas of these writers in some depth, and consider to what extent they stand up to criticism by such notable 'Greek' contenders as P. F. Strawson and Gareth Evans. ;I first give neutral accounts of the key-concepts on which subsequent arguments are based. These are the immunity to error through misidentification of certain 1st-person utterances, the guaranteed reference of 'I', avowal, and the Generality Constraint. I consider the close relation of Trojanism to solipsism and behaviourism, and then assess the effectiveness of two arguments for that viewpoint--Anscombe's Tank Argument and the argument from IEM. Though each is appealing, neither is decisive; to assess Trojanism properly we need to look at the non-assertoric thesis of avowals, which alone affords the prospect of a resolution of the really intractable problems of the self generated by Cartesianism. ;In the course of the latter assessment I consider the different varieties of avowal, broadening the discussion beyond the over-used example 'I am in pain'. I explore Wittgenstein's notion of 'expression', and discuss how this notion may help to explain the authority a subject possesses on his mental states as expressed in avowals. My conclusion is that an expressive account of avowals can provide a satisfactory counter to the Cartesian account of authority without our needing recourse to a non-assertoric or even to a non-cognitive thesis. ;Discussion of self-consciousness is implicit in discussion of the Homeric Opposition, but there is in addition a short chapter on the concept itself. (shrink)

In the early 1990s, managers at Exxon decided to seek lower cost disposal in Louisiana for oil-field wastes declared hazardous in Alabama. This decision resulted in injuries to the residents of Grand Bois, Louisiana; the disposal company; Exxon; and the oil industry in the state. Given the need for business and society to manage business operations for mutual benefit, it is essential to understand why businesses injure the public so that similar incidents do not happen again. The authors use three (...) analytical perspectives to suggest how corporations may make unethical decisions without purposefully setting out to do so: their managers may fail to understand changing social expectations for corporate behavior; they may adopt organizational structures, policies, and procedures that block ethical action in the name of efficiency; and they may follow unwritten rules of behavior for career success that exclude ethics. These perspectives suggest that individual Exxon managers may not have been making greed-based decisions, weighing corporate gains against harms to others. The situation more likely involved a failure, for the reasons discussed, to raise ethics questions in making business decisions. This explanation does not make much difference to those injured nor does it absolve those who made the decisions. It does make a difference to society and to companies seeking to understand factors that have to be overcome in any large corporation that wishes to prevent such events from occurring. (shrink)

Management practitioners and scholars have worked diligently to identify methods for ethical decision making in international contexts. Theoretical frameworks such as Integrative Social Contracts Theory (Donaldson and Dunfee, 1994, Academy of Management Review 19, 252–284) and more recently the Global Business Citizenship Approach [Wood et al., 2006, Global Business Citizenship: A Transformative Framework for Ethics and Sustainable Capitalism. (M. E. Sharpe, Armonk, NY)] have produced innovations in practice. Despite these advances, many managers have difficulty implementing these theoretical concepts in daily (...) practice. Using the example of recent decisions by internet service providers Google, Yahoo, and MSN regarding censorship requirements in China, we offer six heuristic questions to help managers to resolve cross-cultural ethical conflicts in which the firm’s way of doing business differs from the practice in the host country. Recognizing that companies can take different approaches to law and ethics (Paine, 1994, Harvard Business Review 72(2), 107–117), our aim is to provide a management decision process to deal with demands or opportunities for engaging in questionable business practices in a host country. (shrink)