This book provides an analysis of the debate surrounding cultural diversity, and attempts to reconcile the seemingly opposing views of "ethical imperialism," the belief that each individual is entitled to fundamental human rights, and cultural relativism, the belief that ethics must be relative to particular cultures and societies. The author examines the role of cultural tradition, often used as a defense against critical ethical judgments. Key issues in health and medicine are explored in the context of cultural diversity: the physician-patient (...) relationship, disclosing a diagnosis of a fatal illness, informed consent, brain death and organ transplantation, rituals surrounding birth and death, female genital mutilation, sex selection of offspring, fertility regulation, and biomedical research involving human subjects. Among the conclusions the author reaches are that ethical universals exist, but must not be confused with ethical absolutes. The existence of ethical universals is compatible with a variety of culturally relative interpretations, and some rights related to medicine and health care should be considered human rights. Illustrative examples are drawn from the author's experiences serving on international ethical review committees and her travels to countries in Africa, Asia, and Latin America, where she conducted educational workshops and carried out out her own research. (shrink)

What makes individuals, groups, or even entire countries vulnerable? And why is vulnerability a concern in bioethics? A simple answer to both questions is that vulnerable individuals and groups are subject to exploitation, and exploitation is morally wrong. This analysis is limited to two areas. First is the context of multinational research, in which vulnerable people can be exploited even if they are not harmed, and harmed even if they are not exploited. Second is the situation of women, who are (...) made vulnerable in cultural settings or in entire countries in which they are oppressed and powerless. (edited). (shrink)

ABSTRACTComparative effectiveness studies, referred to here as “usual-care” trials, seek to compare current medical practices for the same medical condition. Such studies are presumed to be safe and involve only minimal risks. However, that presumption may be flawed if the trial design contains “unusual” care, resulting in potential risks to subjects and inaccurately informed consent. Three case studies described here did not rely on clinical evidence to ascertain contemporaneous practice. As a result, the investigators drew inaccurate conclusions, misinformed research participants, (...) and subjects’ safety was compromised. Before approving usual-care protocols, IRBs and scientific review committees should evaluate the quality and completeness of information documenting usual-care practices. Guidance from governmental oversight agencies regarding evidence-based documentation of current clinical practice could prevent similar occurrences in future usual-care trials. Accurate information is necessary to ensure that trials comply with government regulations that require minimizing research risks to subjects and accurate informed consent documents. (shrink)

William James (1842-1910) was both a philosopher and a psychologist, nowadays most closely associated with the pragmatic theory of truth. The essays in this Companion deal with the full range of his thought as well as other issues, including technical philosophical issues, religious speculation, moral philosophy and political controversies of his time. The relationship between James and other philosophers of his time, as well as his brother Henry, are also examined. By placing James in his intellectual landscape the volume will (...) be particularly useful to teachers and students outside philosophy in such areas as religious studies, history of ideas, and American studies. New readers and nonspecialists will find this the most convenient and accessible guide to James currently available. Advanced students and specialists will find a conspectus of recent developments in the interpretation of James. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Women and Health Research:A Report from the Institute of MedicineAnna C. Mastroianni (bio), Ruth Faden (bio), and Daniel Federman (bio)In recent years, claims have been made by segments of the research community and by women's health advocacy groups that clinical research practices and policies have not benefitted women's health to the same extent as men's health. Central to these claims has been an assertion that women have been (...) inadequately represented as subjects of clinical studies and that as a result neither health conditions unique to women—e.g., menopause—nor women's manifestations of health problems affecting both sexes—e.g., heart disease—have been investigated sufficiently.The scientific community, including federal agencies that sponsor and regulate clinical studies, is increasingly responsive to these claims and is taking steps to raise the level of women's participation in clinical studies. Controversy and concern have surrounded these actions, however. Two of the claims that have been made are: (1) that women are more difficult to study than men because of their cyclical hormonal changes; and (2) that conducting gender-specific subgroup analyses would increase the size of study populations, raise the cost of studies, and thereby reduce the number of studies that could be performed with the limited resources available. In addition, controversy over the inclusion of women of childbearing potential and pregnant women has been particularly salient. Concerns have been expressed about avoiding potential harm to existing or potential fetuses and about the possible legal and financial ramifications of such harm. A further concern involves the perceived difficulties in enrolling women in studies and retaining them for the duration of the studies.Against this backdrop, the Office of Research on Women's Health at the National Institutes of Health (NIH) asked the Institute of Medicine (IOM) in October 1992 to establish the Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies. The Committee's charge was to: (1) consider the ethical and legal implications of including women, particularly pregnant women and women of childbearing potential, in clinical studies; (2) examine known instances of litigation regarding injuries to research subjects [End Page 55] and describe existing legal liabilities and protections; and (3) provide practical advice on these issues for consideration by NIH, institutional review boards (IRBs), and clinical investigators.The 16 Committee members came from diverse backgrounds: bioethics, law, epidemiology and biostatistics, public health policy, obstetrics and gynecology, clinical research, pharmaceutical development, social and behavioral sciences, and clinical evaluative sciences.1 Chaired by two of the authors of this article, Ruth Faden and Daniel Federman, and coordinated by the third, IOM Study Director Anna Mastroianni, the Committee met five times over a fourteen-month period, convened a one-and-one-half day invitational workshop, and commissioned several background papers. The Committee's deliberations were complicated by the announcement of new federal policies late in its term. Specifically, the Food and Drug Administration (FDA) issued guidelines (FDA 1993) to replace its 1977 guidelines, which prohibited the inclusion of women of childbearing potential in early phases of most clinical drug trials. In addition, Congress passed the NIH Revitalization Act of 1993 (P.L. 103-43), which contains provisions mandating the inclusion of women and racial and ethnic minorities in NIH-sponsored clinical research. In February 1994, the IOM Committee publicly issued its final report and recommendations, Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies, publishing the workshop presentations and commissioned papers in a separate volume.Deliberations of the CommitteeA number of issues arose at the outset as the Committee considered its charge. A few members initially believed that verification of the underrepresentation of women relative to men in clinical studies as a whole was a prerequisite to providing policy recommendations. Others believed that such an examination would be an important contribution to the knowledge base, but that it was not necessary for addressing the Committee's charge. As summarized in the Committee's report, the Committee's research indicated that firm conclusions about the relative underrepresentation of women could not be drawn from the available data because of the lack of systematic information... (shrink)

Applied ethics, a subdiscipline of philosophy, lends itself to an encyclopedia format because of the many industries and intellectual fields that it encompasses. The Encyclopedia of Applied Ethics is based on twelve major categories, such as Biomedical Ethics and Environmental Ethics. Religious traditions that embody normative beliefs, as well as classical theories of ethics, are explored in a non-judgmental manner. Each of the twelve categories is divided into discrete areas that are covered by 5,000-6,000 word articles. Each of the 281 (...) articles begins with a definition of the subject and includes a table of contents, glossary of key terms, and bibliography. Second- and third- level headings, boxes, sidebars, and the like emphasize the reference-oriented nature of the material. The four volumes are arranged in an A-Z format, with a complete subject index at the end of the last volume. Articles are written by international experts, arranged alphabetically by title, not by subject, and cross-referenced so the reader can locate relevant information in other articles. One of Library Journal's Best Reference Sources for 1997! One of the CHOICE Outstanding Academic Books for 1998! Cross-references appear in each article to refer readers to related information A glossary and bibliography in each article provide readers with tools for learning and creative thinking. (shrink)

(2000). For Utopia: The (limits of the) Utopian function in late capitalist society. Critical Review of International Social and Political Philosophy: Vol. 3, The Philosophy of Utopia, pp. 25-43.

Lacan with the Philosophers creates a dialogue between the oeuvre of psychoanalyst Jacques Lacan and philosophy. Major philosophical figures to which Lacan vastly referred are examined around key concepts fundamental to philosophy - being, truth, knowledge, the good, the subject.

Elements comprising a set of building blocks for a feminist reconstruction of citizenship might include: a critical synthesis of citizenship as a status and a practice; strengthening the inclusive side of citizenship (within and across nation-states); the principle of differentiated universalism, addressing tensions between an analysis grounded in difference and the universalism standing at the heart of citizenship; and a challenge to the binary thinking that constrains the articulation of women's claims to citizenship.

In his major philosophical opus, Kevod Elohim , written in Hebrew, Joseph ben Shem Tov investigates the summum bonum of man, which consists in the similarity to God's perfection called the "Glory of God" insofar as it can be realized by human nature. Opinions are divided, however, as to the nature of this greatest good. Some Jewish scholars claim that man's final purpose is in the observance of the 613 commandments of the Torah. According to the philosophers, the proofs of (...) Aristotle show irrefutably that man's highest happiness is in the grasping of cognition through reason. Other Jewish scholars assert that the mysteries of the Torah can be explored through philosophy and therefore the Torah and the sciences fulfill in principle the same purpose. This position, however, is objectionable to some believers on the ground that it denies the divine character of religion. On the other hand, to deny the proofs of Aristotle would be to coerce the findings of reason. If religion is the supreme good, it cannot contradict reason. Since the truth cannot be in conflict with the truth, Joseph's task is to compare, for the first time, the Nicomachean Ethics of Aristotle with the Torah to determine to what extent they agree or conflict. His method is to assemble all statements of Aristotle and his commentators on this subject and to submit them to critical analysis. Joseph's motivation is to justify the pursuit of Greek science, especially in view of his father Shem Tov ibn Shem Tov's virulent repudiation of philosophy, and to guide the perplexed of his generation who could not reconcile Greek wisdom with their faith. Joseph finds that the speculative eudemonia of Aristotle accords with the Torah. In an innovative interpretation of the Ethics, he reveals that Aristotle believed in individual providence over those who perfected their intellect and over those who practiced the ethical virtues. Joseph also identifies the study of Torah with the activity of speculation similar to the activity of the Separate Intellects. He finds no basis, however, in Aristotle's writings for the immortality of reason. Since the religious imperative grants immortality, it is infinitely greater than the eudemonia of reason. Thus, from a position of rapprochement between science and faith, Joseph considers them under the aspect of eternity and emerges with a complete denial of any ultimate resemblance between the two spheres. (shrink)

Analysis and comparison of genetic screening programs shows that the extent of development of programs varies widely across Europe. Regional variations are due not only to genetic disease patterns but also reflect the novelty of genetic services. In most countries, the focus for genetic screening programs has been pregnant women and newborn children. Newborn children are screened only for disorders which are treatable. Prenatal screening when provided is for conditions for which termination may be offered. The only population screening programs (...) for adults are those for thalassaemia carrier status in Cyprus, Greece and Italy. Social responses to genetic screening range from acceptance to hostility. There is a fundamental tension between individual and communi ty in the debates in various European countries about implementation of screening programs. Opposition to genetic screening is frequently expressed in terms of arguments about "eugenics" with insufficient regard to the meaning of the term and its implications. Only a few countries have introduced explicit legislation on genetic screening. Legislation to address discrimination may provide more safeguards than legislation protecting genetic information itself. (shrink)

The possibilities of genetic engineering, particularly as applied to human beings, have provoked considerable debate for over two decades, but more recently the focus of public concern, at least, has turned to genetically modified food. Food has occasionally caught the attention of philosophers and bioethicists but is now ripe for further attention in the light of the implications of GM for policy in health, economics and politics. Macer has identified opposing reactions to novel foods—to prefer to eat down the food (...) chain, on the one hand, and to embrace technology, on the other. One question that has given rise to some interest is why consumer attitudes to genetically modified food have been so much more strongly adverse in Europe, particularly in the UK, than in the USA. This paper explores the ways in which the food ethics debate has been constructed in recent debates in the UK, with special reference to the similarities to and differences from what are on the face of it analogous debates in medical ethics. What is special about food, as opposed to drugs, which makes it appropriate or inappropriate to construct the arguments in the terms that currently predominate? This will involve looking in particular at the application of the principle of autonomy and the argument from consumer choice. (shrink)

The mechanisms governing anterior‐posterior and dorsal‐ventral polarity in Drosophila melanogaster had previously been considered as independent processes. However, two papers(1,2) now reveal that both axes are initiated during oogenesis by the same pathway, and also clearly demonstrate that one is dependent on the other.

This paper explores how emotions are expressed in the endangered Gunwinyguan language Kunbarlang and compares these expressions to those in the neighbouring Gunwinyguan language Bininj Kunwok, and neighbouring languages from other language families, Mawng (Iwaidjan) and Ndjébbana (Maningridan). As well as considering body-based emotion expressions and the tropes (metaphors and metonymies) they instantiate, we consider the range of other (non-body-based) expressions and tropes available in each language. These provide an important point of comparison with the body-part expressions, which are limited (...) to expressions based on noun incorporation in the Gunwinyguan languages and, correspondingly, a more limited range of tropes. By outlining and comparing the linguistic tropes used to express emotions in these four languages in the highly multilingual yet socioculturally unified context of western Arnhem Land, we aim to shed further light on the relationships between linguistic figurative features and conceptual representations of emotions. (shrink)

It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a (...) series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning. (shrink)

The role of government in assuring population access to affordable and appropriate health care represents a central question for any nation. Of particular concern is access to prescription drug coverage, not only because of the vital role played by drugs in modern medicine, but also because of their high costs. This article examines the sharply contrasting prescription drug coverage and payment policies found in Australia and the U.S. – strong political allies and international trading partners – and describes how key (...) U.S. interests have sought, through an aggressive trade agenda, to expand markets for U.S. goods and services, even when market expansions clash with other nations’ contrasting emphasis on social equity and fairness. Indeed, the nation’s bilateral free trade negotiations have brought the contours of this policy schism into sharp relief. (shrink)

Throughout the 3-year war in Lebanon (1982-1985) and throughout the 7 years of the first Intifada (1987-1994), about 170 objecting reservists chose to adopt an unconventional mode of moral resolution for their dilemma about service in the conflict: they disobeyed the order to serve in the war zone when their unit was called up. They argued that such service would contradict the dictates of their conscience. At the outset, the intention of most of these reservists was to comply with orders (...) for general military service. They asked to serve within the Green Line. When their request was overruled and they continued to disregard their call-up, they were charged with a disciplinary offense (Israel has no legal provision for selective conscientious objection). They subsequently were tried by court-martial and were sentenced to 14-35 days in military prison, some of them more than once when they refused additional drafts. Their major conscientious claims revolve around two major constraints: resisting the unfair physical load of military reserve service and resisting the obligation to face morally no-win situations. I would further argue that even though most of the public and the senior army echelons were familiar with these two types of moral voices, they preferred to remove the conscientious soldiers from their posts, or to ignore the claims themselves. (shrink)

Technological innovations have transformed our culture's ways of thinking about procreation and pregnancy, and about health and illness. Until not so long ago, the ongoing processes inside women's bodies as they gestated their future babies was up to conjecture. In Western industrialized countries, pregnancy was the slow process during which a woman gradually came to accept the fact that she was sharing her bodily space with another, and that now, as well as after the baby emerged, the primary responsibility for (...) that new person's survival would be hers. (shrink)

Der Beitrag setzt sich kritisch mit dem Prinzip des prokreativen Wohltuns von Julian Savulescu und seinen Implikationen für den Umgang mit der Präimplantationsdiagnostik auseinander. PB fordert angehende Eltern dazu auf, aus mehreren möglichen zukünftigen Kindern dasjenige auszuwählen, dessen Leben voraussichtlich am besten verlaufen wird. Paare mit Kinderwunsch sind danach zumindest unter bestimmten Umständen moralisch verpflichtet, eine PID in Anspruch zu nehmen, um die Weitergabe genetisch bedingter Krankheiten zu verhindern. Die Auswahl von Embryonen im Rahmen einer PID kann jedoch nur dann (...) mit dem Wohlergehen des zukünftigen Kindes begründet werden, wenn man die entsprechende Wohltunspflicht mit Savulescu und Kahane als „unpersönliche“ moralische Pflicht versteht. PB wirft daher die Frage nach der Relevanz unpersönlicher Erwägungen für Entscheidungen über Fortpflanzung und Familiengründung auf. Gegen Savulescu und Kahane argumentiere ich dafür, reproduktive Verantwortung als einen integralen Aspekt elterlicher Verantwortung und damit als personenbezogene Verantwortung zu deuten, und verteidige diese Konzeption reproduktiver Verantwortung gegen Einwände, die sich aus einem von Savulescu und Kahane konstruierten hypothetischen Szenario – dem Röteln-Beispiel – ergeben. (shrink)

This book discusses ways for people to handle today's bioethical issues in the context of America's history and culture--and from the perspective of various ...

Four key guidance points in the UNAIDS guidance document, Ethical Considerations in HIV Preventive Vaccine Research, are compared wit.