Much has been written about recidivist punishments, particularly within the area of criminology. However there is a notorious lack of penal philosophical reflection on this issue. This book attempts to fill that gap by presenting the philosopher’s view on this matter as a way of furthering the debate on recidivist punishments.

Much has been written about recidivist punishments, particularly within the area of criminology. However there is a notorious lack of penal philosophical reflection on this issue. This book attempts to fill that gap by presenting the philosopher’s view on this matter as a way of furthering the debate on recidivist punishments.

I defend a form of preventive detention through the creation of an offence of ‘being a persistent violent dangerous offender’. This differs from alternative proposals and actual habitual offender laws that impose extra periods of incarceration on offenders after they have completed the sentence for their most recent crime or as a result of a certain number of prior convictions. I, instead, would make ‘being a persistent violent dangerous offender’ an offence itself. Persons to be preventively detained would be tried (...) and convicted of this offence. My approach would then have one significant advantage: provided the elements of being a PVDO could be rendered sufficiently determinate, punishing persons under such an offence would comport with central rule of law values, most importantly legality and fair notice, as well as principles of proportionality in sentencing. (shrink)

Mealey's sociobiological model of sociopathy could profit from attachment theory, in particular, the theory and research on the basis of the Adult Attachment Interview (Main & Goldwyn 1985–1993). Findings of an adult attachment study in a forensic psychiatric setting are summarized. Three attachment-oriented strategies for families, schools, and forensic settings are proposed to help reduce or prevent secondary sociopathy and criminal recidivism.

Crime-preventing neurointerventions (CPNs) are increasingly being used or advocated for crime prevention. There is increasing use of testosterone-lowering agents to prevent recidivism in sexual offenders, and strong political and scientific interest in developing pharmaceutical treatments for psychopathy and anti-social behaviour. Recent developments suggest that we may ultimately have at our disposal a range of drugs capable of suppressing violent aggression, and it is not difficult to imagine possible applications of such drugs in crime prevention. But should neurointerventions (...) be used in crime prevention, and may the state ever permissibly impose CPNs as part of the criminal justice process? It is widely thought that preventing recidivism is one of the aims of criminal justice, yet existing means of pursuing this aim are often poorly effective, restrictive of basic freedoms, and harmful. Incarceration, for example, tends to be disruptive of personal relationships and careers, detrimental to physical and mental health, highly restrictive of freedom of movement and association, and rarely more than modestly effective at preventing recidivism. Neurointerventions hold the promise of preventing recidivism in ways that are more effective and more humane, but the use of CPNs in criminal justice raises several ethical concerns. CPNs could be highly intrusive and may threaten fundamental human values, such as bodily integrity and freedom of thought, and humanity has a track record of misguided, harmful, and unwarrantedly coercive use of neurotechnological ‘solutions’ to criminality. This collection brings together original contributions from emerging scholars and internationally renowned moral and political philosophers to address these issues. (shrink)

Herbert, Dilinie The lived experiences of prisoners and the delivery of healthcare into this population raise important ethical issues. The prison population is made up largely of people who have experienced social and economic disadvantage, and who often have a diagnosed mental health condition. International and national authorities recognise that the health needs of prisoners are complex but that slow progress is being made to reform and improve existing practices. This article will demonstrate that alongside the provision of primary care, (...) healthcare in prisons must also focus on the social and psychological issues and behaviours of prisoners in order to prevent recidivism. (shrink)

Surgical castration of sex offenders has been used in several countries to prevent sexual recidivism and is still practiced in several states in the United States. In Europe, it has remained in limited use in Germany and in the Czech Republic (Douglas et al. 2013). Since the 1960s, most jurisdictions have replaced irreversible surgical castration of sex offenders with reversible chemical castration with anti-androgen drugs. In Denmark, use of surgical castration was stopped in 1970, and since the late 1980s, (...) serious sex offenders have on a trial basis been treated with anti-androgen drugs (Hansen and Lykke-Olesen 1997). In 1997, an official treatment program for sex offenders was introduced on a trial basis, and in 2011 this scheme was made permanent (Nielsen 2001).The first part of the scheme covers persons with a suspended sentence with conditions of sexological treatment. This program serves as an alternative to suspended sentences of up to one and a half years of prison for crimina. (shrink)

There are a number of important links and similarities between public health and safety. In this extended essay, Gregg D. Caruso defends and expands his public health-quarantine model, which is a non-retributive alternative for addressing criminal behavior that draws on the public health framework and prioritizes prevention and social justice. In developing his account, he explores the relationship between public health and safety, focusing on how social inequalities and systemic injustices affect health outcomes and crime rates, how poverty affects (...) brain development, how offenders often have pre-existing medical conditions (especially mental health issues), how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, how treatment and rehabilitation methods can best be employed to reduce recidivism and reintegrate offenders back into society, and how a public health approach could be successfully applied within the criminal justice system. Caruso's approach draws on research from the health sciences, social sciences, public policy, law, psychiatry, medical ethics, neuroscience, and philosophy, and he delivers a set of ethically defensible and practically workable proposals for implementing the public health-quarantine model. The essay begins by discussing recent empirical findings in psychology, neuroscience, and the social sciences that provide us with an increased understanding of the social and neurological determinants of health and criminal behavior. It then turns to Caruso's public health-quarantine model and argues that the model provides the most justified, humane, and effective approach for addressing criminal behavior. Caruso concludes by proposing a capability approach to social justice grounded in six key features of human well-being. He argues that we cannot successfully address concerns over public health and safety without simultaneously addressing issues of social justice—including the social determinants of health (SDH) and the social determinants of criminal behavior (SDCB)—and he recommends eight general policy proposals consistent with his model. (shrink)

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of (...) the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism. (shrink)

Restorative justice should have greater weight as a criterion in criminal justice sentencing practice. It permits a realistic recognition of the kinds of harm and damage caused by offences, and encourages individualized non-custodial sentencing options as ways of addressing these harms. Non-custodial sentences have proven more effective than incarceration in securing social reconciliation and preventing recidivism, and they avoid the serious social and personal costs of imprisonment. This paper argues in support of restorative justice as a guiding idea in (...) sentencing. As part of this defence, it considers whether the use of the idea of restorative justice will conflate criminal law with civil law or displace the authority of the criminal courts, and whether the sentences it recommends are best thought of as punishments or alternatives to punishment. (shrink)

Suppose we agree to reject the view that privacy has narrow scope and consequently is irrelevant to the constitutional privacy cases. We then have (at least) these two options: (1) We might further emphasize and draw out similarities between tort and constitutional privacy claims in order to develop a notion of privacy fundamental to informational and Fourth Amendment privacy concerns as well as the constitutional cases. We can cite examples indicating this is a promising position. Consider consenting homosexuality conducted in (...) one's home, for instance. We view it as a private matter, whether the state is seeking to regulate the behavior, or if others are attempting to gain or exploit information about it. I believe basic conceptual similarities between tort and constitutional interests can be identified by showing that there is a range of similar reasons for protecting both tort and constitutional privacy concerns. We might worry, however, that a comprehensive concept of privacy may be too general to be very useful, given that privacy violations can be so diverse, and can arise, for example, from misuse of confidential information, from conduct that is intrusive even if no information is gained or disclosed, from disturbance of an intimate relationship, or from disruption of various other important aspects of one's life.(2) We could concede that whatever “privacy” means in the tort and Fourth Amendment cases, it means something different in the constitutional cases. Nevertheless, we might take that “something else” seriously as a distinct but legitimate use of the term which is not “spurious” but is reflected in our ordinary language. This appears to me to be a fruitful alternative. After all, contrary to Henkin's view that tort privacy is “what most people mean by privacy,” the term is often used in contexts beyond informational privacy and clearly related to the interests at stake in the constitutional cases. Thus, for example, in a pamphlet explaining how to protect children by teaching them how to say “No!” to strangers without making them paranoid or antisocial, parents and teachers are told, Children have a right to privacy. Teach it. Reinforce it. One of the ways to help children prevent sexual assault is to encourage them to develop a sense of physical integrity. A sense that they have a right to their own body space and privacy. Just as we allow them to close the door when they use the bathroom, we must allow them to say no to any unwanted physical affection and touch. Flora Calao and Tamar Hosansky, “The Key to Having Fun is Being Safe: Teaching Personal Safety to Children,” The Safety and Fitness Exchange, 1123 Broadway, N.Y., N.Y. 10010. Unfortunately, the most obvious starting point for identifying the sense of private relevant to the constitutional cases is extremely worrisome. The Court itself has said ... only personal rights that can be deemed “fundamental”...are included in this guarantee of personal privacy...the right has some extension to activities relating to marriage...procreation...contraception...family relationships... and child rearing and education.Roe v. Wade, 410 U.S. 113 (1973).The difficulty, of course, is that little more is offered by way of explanation of which rights are “personal” or “fundamental” or both. Focusing on marriage makes Roe v. Wade difficult to understand given that Ms. Roe was unmarried, and attending only to family issues does not help us make sense of the Stanley case protecting one's right to view pornography in one's home. It is perhaps more problematic that decisions such as what color shoes to wear are reasonably viewed as personal, yet are far from fundamental enough to warrant protection. And regulations governing the draft and employment, for example, are not viewed as privacy invasions although they might be said to interfere with matters of one's life that are both fundamental and personal in the vague sense described.Before we give up in frustration, however, I would urge that we recall that even in tort law the notion of privacy has been evolving through a constellation of judgments. Although there is no fixed way of using the term which we then proceed to analyze, the concept of privacy has not in those cases been taken to be meaningless or empty. Similarly, there is reason to believe that the scope of a “personal and fundamental” notion of privacy relevant to the constitutional cases can be further delineated through a consideration of cases, especially since it seems to me that in many cases application of the term is clear and unproblematic. A decision to have a vasectomy, for example, can uncontroversially be said to be a personal and fundamental one, and it is in that sense private. We fail to acknowledge the personal significance in an individual's life of forcing or refusing him the operation if we deny that this important sense of privacy is relevant to such a decision merely because an interest in determining for oneself what one ought to do is also at risk.Of course, once it is settled that something is a private matter, it is a separate issue to decide whether or not, in some social context, an invasion of it can be justified. Thus, I would claim, a mandatory sterilization program for male recidivists or for those in a country suffering grave poverty and overpopulation does invade privacy, and the social or legal question is whether or not the invasion can, in the particular circumstances, be justified. Although all will agree that both individual and social interests must be balanced by moral philosophers as well as the courts, in conflicts we will not always agree on the weight to be accorded individual claims.I have not provided a constitutional defense for citing privacy as one right at stake in the constitutional privacy cases. Nor have I attempted to enter the debate about how strictly to interpret the Constitution. But if I am correct, then we can agree there is an important interest in privacy at issue in those cases without merely conflating privacy and autonomy or liberty, and can continue the process of marking out its boundaries. If we reach such agreement, we will have made considerable progress. Moreover, the implications of this view are significant. Current constitutional standards, controversial though they may be, require “strict scrutiny” for cases concerning “fundamental values,” and privacy has been judged to be one such value. Thus these privacy claims have a greater chance of being protected when they conflict with other rights or general interests than they would have if only liberty, or freedom from governmental interference, were involved. (shrink)

The policy adopted by housing authorities of denying prospective tenants with a criminal record access to housing is an important barrier to ex-offenders seeking somewhere to live. The policy is legal, but are there any good reasons in favor of it when we know that having no, or limited, access to secure and affordable housing increases the probability of recidivism? The primary aim of this article is to critically discuss two central reasons that have been given for denying people (...) with criminal records access to housing: that doing so will prevent crime, and that the policy reduces fear of crime. We also try to evaluate an argument for the conclusion that current law, and the policies that follows wrongfully discriminate against people with criminal records. The general thrust of the article is that arguments for this practice turning on its crime preventive effect, and its role in reducing or preventing fear of crime, are unpersuasive. We then explained why, in our view, excluding ex-offenders from housing amounts to wrongful discrimination against them. Our analysis suggests that ex-offenders, apart from a few excemptions, ought to be allowed access to housing to the same extent as other people. (shrink)

The central premise is that a significant amount of sex offending stems from unusual or inappropriate sexual preferences that appear in early adolescence, are relatively stable, and immutable. In those ways, they are like more ordinary sexual preferences, generating sexual impulses that are insistent. Individuals are strongly tempted to act on them, alternatives to satisfying them are unfulfilling, and complete long-term control of such impulses is unlikely. Yet, since individuals with sexual preferences for inappropriate objects or activities are neither morally (...) nor legally permitted to act on them, they find themselves in a terrific bind. The public is, to some extent, correct to not trust the individuals with such preferences and to attempt to monitor or control them. However, most such efforts appear ineffective and counterproductive. Recidivist sex offenders are particularly worrisome. The possibility of voluntary castration for such offenders, in lieu of preventive detention or other more restrictive measures, is explored. (shrink)

Pay for Success (PFS), also known as Social Impact Bonds, is a new contracting mechanism to fund prevention programs, where investors provide capital to implement a social service -- for example, to reduce recidivism by former prisoners. If the service provider achieves agreed upon outcomes, the government pays the investor, usually with a rate of return, based on savings from decreased use of more costly remedial services, such as incarceration. Federal, state, and local agencies play an important role (...) in improving social outcomes for society's most vulnerable populations. A small number of state, local, and foreign governments are employing PFS to fund efforts designed to better serve these vulnerable populations. This book examines how selected PFS projects have been structured and what potential benefits these projects can provide; how selected PFS contracts have been structured to address potential project risks; and the potential roles for the federal government's involvement in PFS projects. This book also provides an overview of the first State-led Pay for Success and Social Impact "Bond" (SIB) project in the nation; examines some of the arguments for and against The Payment by Results (PbR) approach to delivery of public services; and looks at current and planned projects in rehabilitation, welfare to work, the NHS, children's social services and with rough sleepers and with vulnerable young people. (shrink)

It is often said that the institutions of criminal justice ought or—perhaps more often—ought not to rehabilitate criminal offenders. But the term ‘criminal rehabilitation’ is often used without being explicitly defined, and in ways that are consistent with widely divergent conceptions. In this paper, we present a taxonomy that distinguishes, and explains the relationships between, different conceptions of criminal rehabilitation. Our taxonomy distinguishes conceptions of criminal rehabilitation on the basis of (i) the aims or ends of the putatively rehabilitative measure, (...) and (ii) the means that may be used to achieve the intended end. We also explore some of the implications of each conception, some of the payoffs of a taxonomy of the kind we offer, and some areas for future work. (shrink)

The target article by Laacke et al. focuses on the specific context of identifying people in social media with a high risk of depression by using artificial intelligence technologies. I...

In discussions of the ethics of human gene therapy, it has become standard to draw a distinction between the use of human gene transfer techniques to treat health problems and their use to enhance or improve normal human traits. Some dispute the normative force of this distinction by arguing that it is undercut by the legitimate medical use of human gene transfer techniques to prevent disease - such as genetic engineering to bolster immune function, improve the efficiency of DNA repair, (...) or add cellular receptors to capture and process cholesterol. If disease prevention is a proper goal of medicine, these critics argue, and the use of gene transfer techniques to enhance human health maintenance capacities will help achieve that goal, then the “treatment/enhancement‘ distinction cannot define the limits of legitimate gene therapy. In this paper, I argue that a line can be drawn between prevention and enhancement for gene therapy (and thus between properly medical and nonmedical uses of gene therapy), but only if one is willing to accept two rather old-fashioned claims: 1) Some health problems are best understood as if they were entities in their own right, reifiable as processes or parts in a biological system, with at least as much ontological objectivity and theoretical significance as the functions that they inhibit. 2) Legitimate preventive genetic health care should be limited to efforts to defend people from attack by these more robust pathological entities, rather than changing their bodies to evade social injustices. (shrink)

While many experts and organizations have recognized infertility as a public health issue, most governments have not yet adopted a public health approach to infertility. This article argues in favor of such an approach by discussing the various implications of infertility for public health. We use a conceptual framework that focuses on the dual meaning of the term ‘public’ in this context: the health of the public, as opposed to that of individuals, and the public/collective nature of the required interventions. (...) This analysis highlights the need for a comprehensive public health approach toward infertility, points to some initiatives that are already in place and demonstrates that prevention is currently a neglected—yet much needed——element. We move on to discuss the sensitive nature of prevention initiatives as a probable explanation for their scarcity. We illustrate the complexity of prevention through an analysis of an infertility prevention campaign previously conducted in the United States, which provoked significant controversy. We use a public health communication ethics framework to expose the strengths and the shortcomings of this campaign, and conclude that prevention initiatives targeting infertility can indeed be conducted in a sensible way that promotes autonomy while improving public health. (shrink)

Prior research on corporate misconduct pays extensive attention to single misconduct behaviors. However, little research has addressed recidivism – the repeated behaviors of corporate misconduct. Based on institutional theory and using the context of emerging economies where recidivism plays a considerable role, we propose the path dependency of corporate recidivism and suggest that three influential factors exist: internal preconditioning, inter-organizational imitation, and the prevailing external evaluation. Our event history analysis of 1,036 listed companies in China over the (...) period 2001–2008 statistically confirms our hypotheses. We conclude the paper by outlining the implications for both theory and practice. (shrink)

Kolbe and de Melo-Martin (2023) describe fatal problems in current definitions and measurement of moral distress and injury (MD/I) in medical professionals, which impede development of genuine atte...

In this article, I challenge the risk assessment approach to the ethics of pre-exposure prophylaxis (PrEP) as HIV prevention among men who have sex with men (MSM). Traditional risk assessment focuses on the medical risks and benefits of using medical technologies, but this emphasizes certain risks and benefits over others. The medical risks of using PrEP are presently being overblown and its social and political risks are being overlooked. By recontextualizing risk within the history of HIV and considering the (...) lived experiences of MSM with sex, HIV, and HIV prevention, we can broaden the present risk assessment framework to include all of the relevant risks involved in using PrEP. We can also better situate risk as one of several moral concepts, including trust and solidarity, which move us towards a more nuanced analysis of the social and political effects of PrEP on the relationships and communities of MSM. (shrink)

In clinical research there is a tension between the role of a doctor, who must serve the best interests of the patient, and the role of the researcher, who must produce knowledge that may not have any immediate benefits for the research participant. This tension is exacerbated in HIV research in low and middle income countries, which frequently uncovers comorbidities other than the condition under study. Some bioethicists argue that as the goals of medicine and those of research are distinct, (...) it is a mistake for researchers to assume therapeutic responsibilities while engaging in research. Others propose that there is a duty of care, but disagree as to how this is limited and specified. In this qualitative study, principal investigators from HIV prevention trials discuss their experience of providing medical benefits to participants within the context of conducting research into HIV biomedical prevention technologies. They describe the limitations imposed at times by funders and at times by infrastructure constraints, and canvass the importance of ancillary care provision and capacity building in trial communities. The views of the principal investigators are compatible with the perspective that there is a duty of care, limited by the nature of the research, the depth of the relationship between research and participant, and the capacity of the research site. The therapeutic orientation in HIV prevention trial appears to be indivisible from competent research practise by making concrete and appropriate benefits available to trial participants and their communities that support rather than compete with local infrastructure. (shrink)

The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concerns against the (...) relative standard may not be as convincing as these commentators believe. Our aim is to present the case for a relative standard of environmental risk in order to open a debate on this subject. We conclude by discussing how a relative standard of environmental risk could be defended in the specific case of an HIV vaccine trial among adolescents in South Africa. (shrink)

The proliferation of big data analytics in criminal justice suggests that there are positive frames and imaginaries legitimising them and depicting them as the panacea for efficient crime control. Criminological and criminal justice scholarship has paid insufficient attention to these frames and their accompanying narratives. To address the gap created by the lack of theoretical and empirical insight in this area, this article draws on a study that systematically reviewed and compared multidisciplinary academic abstracts on the data-driven tools now shaping (...) decision-making across several justice systems. Using insights distilled from the study, the article proposes three frames for understanding how the technologies are portrayed. Inherent in the frames are a set of narratives emphasising their ostensible status as vital crime control mechanisms. These narratives obfuscate the harms of data-driven technologies and evince idealistic imaginaries of their capabilities. The narratives are bolstered by unequal structural arrangements, specifically the unevenly distributed digital capital with which some are empowered to participate in technology development for criminal justice application and other forms of penal governance. In unravelling these issues, the article advances current understanding of the dynamics that sustain the depiction of data-driven technologies as prime crime prevention and law enforcement tools. (shrink)

This essay shows how South African Pentecostal teachings about sexuality, particularly HIV prevention and divorce, constrain women’s real and imagined choices. Institutional Review Board–approved fieldwork revealed the prevalence of wives remaining faithful to unfaithful husbands despite high risks of physical abuse and HIV infection. Maintaining the “ideal” of abstinence and faithfulness, male pastors actively oppose condom use and emphasize that “God hates divorce”. In this essay I engage and resist such hermeneutics. Using scripture as source and norm, I construct (...) an A-B-C-D prevention strategy to enhance women’s freedom: Abstain, Be faithful, use Condoms, or Divorce. (shrink)

In order to demedicalize the ethics of pre-exposure prophylaxis as HIV prevention, I consider the social effects on men who have sex with men. The Centers for Disease Control and Prevention considers MSM to be the highest risk group for contracting HIV in the USA. The ethics of using PrEP as HIV prevention among MSM, however, has both a medical dimension and a social dimension. While the medical dimension of the ethics of PrEP includes concerns about side (...) effects, drug resistance and distribution, the social dimension of the ethics of PrEP includes concerns about stigmatization, sexual and romantic relationships and sexual freedom. The medical concerns of the ethics of PrEP may take precedence over the social concerns, but there is a growing body of literature that already addresses the medical concerns. Much less attention has been given to the social concerns of the ethics of PrEP, and in this article, I aim to fill this gap in the literature. Therefore, I focus on the often-overlooked social dimension of the ethics of PrEP to help understand the connection between the risks, relationships and communities of MSM using PrEP as HIV prevention. (shrink)

The concrete insertion of nurses into the context of an inquiry contributes to empirical evaluation research of health promotion programs. As interveners and concrete actors in social movements, nurses are in a privileged position to give realism to a local understanding of the political and cultural context of evaluative research. Drawing on the practice of empirical evaluation research, this paper seeks to generate new methodological approaches in a way that broadens nursing inquiries in community health nursing. It explores new ways (...) of thinking about epistemology and knowledge production in nursing practice. For 5 months an evaluative research project adopting a participatory‐action research approach was conducted with local community actors in an AIDS prevention project in Amazonas (Brazil) in a prostitution setting. An auto‐ethnographic journal was used as a reflective approach for the critical analysis of nursing research activities. This paper calls for a closer relationship between scientific research settings and the sociopolitical and the sociocultural aspects of nursing practice. It increases an incorporation of popular, social and professional experiential learning and skill acquisition in embedded knowledge production. (shrink)

: This essay provides a critical analysis of rape prevention since the 1980s. I argue that we must challenge rape prevention's habitual reinforcement of the notion that fear is a woman's best line of defense. I suggest changes that must be made in the anti-rape movement if we are to move past fear. Ultimately, I raise the question of what, if not vague threats and scare tactics, constitutes prevention.

Background: In 2006, the Centers for Disease Control and Prevention (CDC) recommended three changes to HIV testing methods in US healthcare settings: (1) an opt-out approach, (2) removal of separate signed consent, and (3) optional HIV prevention counseling. These recommendations led to a public debate about their moral acceptability. Methods: We interviewed 25 members from the fields of US HIV advocacy, care, policy, and research about the ethical merits and demerits of the three changes to HIV testing methods. (...) We performed a qualitative analysis of the participant responses in the interviews and summarized the major themes. Results: In general, arguments in favor of the methods were based upon their ultimate contribution to increasing HIV testing and permitting the consequent benefits of identifying those who are HIV infected and linking them to further care. Conclusions: The prevailing theme of ethical concern focused on suspicions that the methods might not be properly implemented, and that further safeguards might be needed. (shrink)

Volume 20, Issue 10, October 2020, Page W1-W3.

Dixon et al. overlook the fact that contact predicts not only favorable out-group attitudes/evaluations, but also cognitions, affect, and behavior. The weight of evidence supporting the benefits of intergroup contact cautions against throwing the (contact) baby out with the bathwater. The goal to “ignite struggles” in pursuit of social equality, we argue, incautiously risks hurling us down the proverbial rabbit hole.

This paper is the companion to “Assessment of Information on Public Health Law Best Practices for Obesity Prevention and Control,” and the fourth of four action papers produced as part of the National Summit on Legal Preparedness for Obesity Prevention and Control, convened June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society for Law, Medicine Ethics. The four action papers present options to address gaps in the four (...) core elements of public health legal preparedness as outlined in the relevant companion papers. The four core elements are: laws and legal authorities; legal competencies for public health professionals to apply those laws and authorities; coordination of law-based efforts across jurisdictions and sectors, and information on public health law best practices. (shrink)

The number of women living with HIV/AIDS is increasing worldwide, and there is an urgent public health need to develop new user-initiated HIV prevention methods, including microbicides. Although funding for microbicide development has increased since 2000, financial support is provided predominantly by governmental agencies and private foundations. Many donors, including the US Agency for International Development (USAID) and the US National Institutes of Health (NIH), have policies that restrict how research funds may be used. Among these are the now-rescinded (...) Mexico City Policy, elements of the US Foreign Assistance Act, and restrictions on non-study-related care. The effect of these restrictions on the design and conduct of clinical research is poorly understood. As part of a recent mapping exercise conducted by the Global Campaign for Microbicides, we reviewed the impact of donor restrictions on seven HIV prevention trials. We found considerable confusion within the HIV prevention field as to whether and how Mexico City and other policies affect the use of research funds. We also found that these donor-imposed policies limited the level of care provided to trial participants and the types of capacity building projects undertaken. (shrink)

Illness narratives invite practitioners to understand how biomedical and traditional health information is incorporated, integrated, or otherwise internalized into a patient’s own sense of self and social identity. Such narratives also reveal cultural values, underlying patterns in society, and the overall life context of the narrator. Most illness narratives have been examined from the perspective of European-derived genres and literary theory, even though theorists from other parts of the globe have developed locally relevant literary theories. Further, illness narratives typically examine (...) only the experience of illness through acute or chronic suffering (and potential recovery). The advent of biomedical disease prevention methods like post- and pre-exposure prophylaxis (PEP and PrEP) for HIV, which require daily pill consumption or regular injections, complicates the notion of an illness narrative by including illness prevention in narrative accounts. This paper has two aims. First, we aim to rectify the Eurocentrism of existing illness narrative theory by incorporating insights from African literary theorists; second, we complicate the category by examining prevention narratives as a subset of illness narratives. We do this by investigating several narratives of HIV prevention from informants enrolled in an HIV prevention trial in Kenya and Uganda in 2022. (shrink)

Heart disease is a complex condition that is a leading cause of death worldwide. It is often seen as a disease of affluence, yet is strongly associated with a gradient in socio-economic status. Its highly complex causality means that many different facets of social and economic life are implicated in its aetiology, including factors such as workplace hierarchy and agricultural policy, together with other well-known factors such as what passes for individual 'lifestyle'. The very untangling of causes for heart disease (...) thus inevitably raises social, moral and political issues. These include the proper role of the individual and of larger social forces in its aetiology, prevention and treatment. The construction of risk factors for heart disease likewise is enmeshed with questions of distributive justice in the responsible targeting of those at risk for heart disease, a debate which has received much overt attention in the medical literature, but less attention within the ethical literature. Strategies for addressing a condition of such complex causality can be highly diverse, from pharmaceutical to social interventions, and value issues attach to the choice and presentation of such strategies. For example, prevention strategies may raise complex issues of responsibility and of judgements of what it is to 'live well'. Further ethical debate on this highly political disease would be welcome. (shrink)

The advent of HIV focussed broad social attention on the group of people most affected by it in Australia, the so-called ‘gay community’. However, what a gay community actually was, and what kind of rights and duties were being attached to it remained unclear. However, it is obvious that such a community — or communities — did not fit the model proposed by communitarian writers like Michael Sandel and Charles Taylor, whereby subjects cannot stand outside their own constitutive attachments. I (...) also consider the common criticism of communitarianism, and see what kinds of collectives can in fact be considered ethical.The first part of this paper looks at the ethical issues surrounding community attachment of this kind in Australia in relation to the ethics of HIV/aids clinical research. In particular I examine the way in which certain forms of gay community attachment can be used to strengthen personal autonomy and check exploitation within the prevention and research process.The second part of this paper draws upon the issues just discussed. In particular I focus on the use of ‘community’ in the research process in developing countries, and suggest ways in which cultural considerations might strengthen autonomy. However, I go on to suggest that in many cases the idea of community has served the opposite purpose, and has in fact been used to oppress certain individuals and groups within the developing world, in the so-called interests of the greater good. In order to avoid this, I suggest a model of social and ethical research whereby all subjects and researchers in the clinical process might stand in greater relationships of equality with each other. (shrink)

Recent scholarship in philosophy of science and technology has shown that scientific and technological decision making are laden with values, including values of a social, political, and/or ethical character. This paper examines the role of value judgments in the design of machine-learning systems generally and in recidivism-prediction algorithms specifically. Drawing on work on inductive and epistemic risk, the paper argues that ML systems are value laden in ways similar to human decision making, because the development and design of ML (...) systems requires human decisions that involve tradeoffs that reflect values. In many cases, these decisions have significant—and, in some cases, disparate—downstream impacts on human lives. After examining an influential court decision regarding the use of proprietary recidivism-prediction algorithms in criminal sentencing, Wisconsin v. Loomis, the paper provides three recommendations for the use of ML in penal systems. (shrink)

(2006). Responding to acts preparatory to the commission of a crime: Criminalization or prevention? Criminal Justice Ethics: Vol. 25, No. 2, pp. 23-39.

The main hypothesis of studies presented in this article is that episodic implicit evaluations toward task-relevant objects determine thinking and decisions by actively placing them within or outside the scope of attention. In these studies we also aimed to test the impact of regulatory focus on implicit evaluations and goal pursuit. We applied the Promotion-Prevention Self-control Scale as a measure of mind-set during thinking in the Wason Selection Task in Study 1 and Island Decision Game in Study 2. Directly (...) after learning of the tasks, participants evaluated objects that constituted the task’s content. The findings are in line with the hypothesis stating that goals influence the way in which objects are automatically evaluated. The effects of promotion mind-set were more pronounced in both studies. Promotion-focused individuals positively assessed objects that serve as a confirmation. The implicit evaluations by prevention-oriented individuals disclosed their falsifying approach to the WST. The positive implicit evaluation of correct objects suggests their sensitivity to information useful for falsification and is consistent with their tendency to cautiously self-control thinking. (shrink)