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)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Philosophising, as Spinoza conceives it, is the project of learning to live joyfully. This in turn is a matter of learning to live together, and the most obvious test of philosophical insight is our capacity to sustain a harmonious way of life. Susan James defends this interpretation and explores Spinoza's influence on contemporary debates.

Many philosophers have been persuaded that if we don’t create our own characters, we cannot be responsible for acts that flow from our characters; they also raise doubts about whether acts that do not flow from our characters can fairly be attributed to us. Both these concerns, however, reflect a simplistic and implausible conception of character and of its relation to our actions and our selves. I suggest a different relationship between character and responsibility: We can be responsible for acts (...) that are in character and also for acts that are out of character, but to be capable of being responsible at all is closely related to the capacity to have a character. I relate this capacity to the exercise of active intelligence—a capacity that is manifested in actions in or out of character, but not in the display of many psychological conditions or disorders. (shrink)

Miranda Fricker?s research carefully negotiates the fields of ethics and epistemology, and the places and points where they overlap and intersect. Her 2007 text Epistemic injustice: Power and the ethics of knowing is particularly noteworthy in this regard. It seamlessly integrates these research areas and, in so doing, turns a critical eye on the common assumption that feminist epistemology, characterized by its focus on the role of gender oppression within knowledge practices, is a marginal field of social epistemology. Fricker challenges (...) her readers to consider the thesis that social and feminist epistemologies are more thoroughly interconnected than is traditionally assumed. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

This paper argues that the various approaches to ethics that bioethicists rely on are not adequate to provide effective moral guidance in how to avoid a series of looming human catastrophes (associated with such threats as environmental degradation, war, extreme poverty, and pandemics). It proposes development of a new approach to ethics, dubbed public ethics, that simultaneously investigates moral responsibilities at multiple levels of human organization from the individual to international bodies. It argues that feminist relational theory can provide guidance (...) to development of this new type of ethics, and it warns against obstacles bioethicists face in its pursuit. (shrink)

We propose that the generalizations of linguistic theory serve to ascribe beliefs to humans. Ordinary speakers would explicitly (and sincerely) deny having these rather esoteric beliefs about language--e.g., the belief that an anaphor must be bound in its governing category. Such ascriptions can also seem problematic in light of certain theoretical considerations having to do with concept possession, revisability, and so on. Nonetheless, we argue that ordinary speakers believe the propositions expressed by certain sentences of linguistic theory, and that linguistics (...) can therefore teach us something about belief as well as language. Rather than insisting that ordinary speakers lack the linguistic beliefs in question, philosophers should try to show how these empirically motivated belief ascriptions can be correct. We argue that Stalnaker's (1984) "pragmatic" account--according to which beliefs are dispositions, and propositions are sets of possible worlds--does just this. Moreover, our construal of explanation in linguistics motivates (and helps provide) responses to two difficulties for the pragmatic account of belief: the phenomenon of opacity, and the so-called problem of deduction. (shrink)

Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in (...) the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of generality, i.e. a political understanding of context. (shrink)

Re-consent in research, the asking for a new consent if there is a change in protocol or to confirm the expectations of participants in case of change, is an under-explored issue. There is little clarity as to what changes should trigger re-consent and what impact a re-consent exercise has on participants and the research project. This article examines applicable policy statements and literature for the prevailing arguments for and against re-consent in relation to longitudinal cohort studies, tissue banks and biobanks. (...) Examples of re-consent exercises are presented, triggers and non-triggers for re-consent discussed and the conflicting attitudes of commentators, participants and researchers highlighted. We acknowledge current practice and argue for a greater emphasis on ‘responsive autonomy,’ that goes beyond a one-time consent and encourages greater communication between the parties involved. A balance is needed between respecting participants' wishes on how they want their data and samples used and enabling effective research to proceed. (shrink)

This paper looks at a range of metaphors used within HIV/AIDS discussions and research in support of the claim that bioethicists should pay serious attention to metaphors. Metaphors shape the ways we think about problems and the types of solutions we investigate. HIV/AIDS is an especially rich field for the investigation of metaphor, since the struggles for dominance among different metaphorical options has been very evident. In the field of medical resarch as well as in the area of public policy, (...) different metaphors support different strategies and, therefore, the choice of metaphor has ethical significance. I argue that feminists should engage in these debates since they have an interest in the metaphors selected. They can also learn to be more self-conscious in choosing politically liberating metaphors in other bioethics contexts. (shrink)

Charles Peirce, Mikhail Bakhtin and Thomas Sebeok all develop original research itineraries around the sign and, despite terminological differences, canbe related with reference to the concept of dialogism and modelling. Jakob von Uexküll’s biosemiosic “functional cycle”, a model for semiosic processes, is alsoimplied in the relation between dialogue and communication.Biological models which describe communication as a self-referential, autopoietic and semiotically closed system (e.g., the models proposed by Maturana,Varela, and Thure von Uexküll) contrast with both the linear (Shannon and Weaver) and (...) the circular (Saussure) paradigms. The theory of autopoietic systems is only incompatible with dialogism if reference is to a linear causal model which describes communication as developing from source to destination, or to the conversation model governed by the turning around together rule. Dialogism understood in biosemiotic terms overlaps with the concepts of interconnectivity,interrelation, intercorporeity and presupposes the otherness relation.As Uexküll says, the relation with the umwelt in nonhuman living beings is stable and concerns the species; on the contrary, in human beings it is, changeableand concerns the single individual, which is at once an advantage and a disadvantage. Thanks to “syntactics”, human beings can construct, deconstruct and reconstruct an infinite number of worlds from a finite number of elements. This distinguishes human beings from other animals and determines their capacity for posing problems and asking questions. The human being not only produces his or her own world, but can also endanger it, and even destroy it to the point of causing the extinction of all other life forms on Earth. The unique capacity for reflection on signs makes human beings responsible for life across the planet, both human and nonhuman. Such reflections shift semiotic research in the direction of semioethics. (shrink)

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was (...) to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities. (shrink)

I reflect on the past, present, and future of the field of bioethics. In so doing, I offer a very situated overview of where bioethics has been, where it now is, where it seems to be going, where I think we could do better, and where I dearly hope the field will be heading. I also propose three ways of re‐orienting our theoretic tools to guide us in a new direction: (1) adopt an ethics of responsibility; (2) explore the responsibilities (...) of various kinds of actors and relationships among them; (3) expand the types of participants engaged in bioethics. (shrink)

Volume 20, Issue 7, July 2020, Page 6-8.

Volume 19, Issue 1, February 2020, Page 78-88.

This article is a critique, first, of the theory of identity advanced by Judith Butler and many of the feminist critics of identity politics, and, second, of identity politics itself. I argue that Butler's rejection of the modernist subject for its opposite, the fictional, substanceless subject, is untenable. Looking to object relations theory, I argue instead for a concept of the subject as an ungrounded ground, occupying a middle ground between the postmodern and the modern subject. With regard to identity (...) politics I argue that instead of populating the political realm with multiple identities, we should instead remove identity entirely from the political realm. (shrink)

The Covid‐19 pandemic has exposed four myths in bioethics. First, the flood of bioethics publications on how to allocate scarce resources in crisis conditions has assumed authorities would declare the onset of crisis standards of care, yet few have done so. This leaves guidelines in limbo and patients unprotected. Second, the pandemic's realities have exploded traditional boundaries between clinical, research, and public health ethics, requiring bioethics to face the interdigitation of learning, doing, and allocating. Third, without empirical research, the success (...) or failure of ethics guidelines remains unknown, demonstrating that crafting ethics guidance is only the start. And fourth, the pandemic's glaring health inequities require new commitment to learn from communities facing extraordinary challenges. Without that new learning, bioethics methods cannot succeed. The pandemic is a wake‐up call, and bioethics must rise to the challenge. (shrink)

The book examines current debates about the emergence of an international legal norm of democratic governance and also considers some of the wider theoretical issues to which those debates give rise. It asks should international law seek to promote democratic political arrangements? If so, on what basis, and using which of the many competing conceptions of democracy?

This book presents the first full translation of the correspondence of Leo Strauss and Gerhard Krüger, showing for each the development of key and influential ideas, along with seven interpretative essays by leading Strauss scholars. During the early to mid-1930’s, Leo Strauss carried on an intense, and sometimes deeply personal, correspondence with one of the leading intellectual lights among Heidegger’s circle of recent students and younger associates. A fellow traveler in the effort to “return to Plato” and reject neo-Kantian conventions (...) of the day, Krüger was also a serious student of Rudolf Bultmann and the neo-orthodox movement in which Strauss also took an early interest. During the most intense years of their correspondence, each underwent significant intellectual development: in Krüger’s case, through a penetrating series of studies of Kant and Descartes, respectively, ultimately leading to Krüger’s conversion to Catholicism; and, in Strauss’s case, through the complex stages of what he subsequently called his “reorientation,” involving what he for the first time calls “political philosophy.” Readers interested in tracing the development of Strauss’s thoughts regarding a theological alternative that he found helpfully challenging—if not ultimately compelling—will find this correspondence to be an accessible point of entry. (shrink)

This essay presents Genevieve Vaughan’s writings on language, communication and social praxis for social change. Mothering/being-mothered is thematized, in the framework of gift logic, as a core practice characterizing human relationships, shedding new light on the properly human in terms of gift economy values.

Successful preimplantation genetic diagnosis to avoid creating a child affected by a genetically-based disorder was reported in 1989. Since then PGD has been used to biopsy and analyze embryos created through in viuo fertilization to avoid transferring to the mother’s uterus an embryo affected by a mutation or chromosomal abnormality associated with serious illness. PGD to avoid serious and early-onset illness in the child-to-be is widely accepted. PGD prevents gestation of an affected embryo and reduces the chance that the parents (...) will be faced with a difficult decision of whether to terminate the pregnancy. More controversial have been PGD to select the sex of the child-to-be for “family balancing”, PGD for mere susceptibility to disease and for late-onset disorders such as Alzheimer diseas, and most controversially, PGD to create a donor child who is Human Leukocyte Antigen (HLA-matched with a preexisting sibling in need of stem cell transplant. (shrink)

situation is one in which all are in great peril and someone must be sacrificed lest all perish. In such situations, it is permissible to do things which would be considered wrong under less drastic circumstances. Proponents of animal rights such as Tom Regan agree that in such circumstances it may be necessary to sacrifice a dog in order to save human life. Is such an admission consistent with calling for the abolition of all scientific research on animals? That is, (...) is scientific research a ‘lifeboat’? The analogy is tempting but flawed. The demand for abolition of animal research is not marred by consistency on this score. Keywords: abolition, animal research, animal rights, lifeboat cases, Tom Regan CiteULike Connotea Del.icio.us What's this? (shrink)

Given that one of the major goals of the practice of Philosophy for Children (P4C) is the development of critical thinking skills (Sharp 1987/2018, pp. 4 6), an urgent question that emerged for one of the authors, who is of Chinese Heritage and a novice practitioner at a P4C summer camp was whether this emphasis on critical thinking might make this practice incompatible with the fabric of Chinese culture. Filial piety (孝), which requires respect for one’s parents, elders, and ancestors (...) is considered an important virtue in Asian culture, as is the preservation of harmony. But if one of the goals of P4C is to teach youngsters to courageously pursue reasoned dialogue, does this not set-up young Asians for serious conflict when they come face-to-face with positions that are articulated by elders, but which are ones to which they are diametrically opposed; a racist grandmother, for instance, or an uncle who insists that those at the Tiananmen Square uprising were nothing but hooligan’s. It is this question that we will explore in this presentation. In the process, we will come to the conclusion that, when positions seem irreconcilable, rather than continuing to pursue rigorous critical interchange that may do little other than escalate insult, the facilitator, rather, ought to move toward creating a deeper understanding of each position juxtaposed against its opposing view (a process that we refer to as ‘collaborative caring’), so as to produce side-by-side understanding, knowing that communal bonds have been maintained and, hence, that the opportunity for genuine reasoned collaborative inquiry on other issues and at future times remains open. (shrink)

The Republic’s political discussion begins with the construction of two contrasting cities: a ‘healthy’ city and a ‘city with a fever’; one defined by environmentally sustainable subsistence practices and the other by ‘luxurious’ over consumption that exceeds the carrying capacity of its land. Plato’s characters proceed to cure the inflamed city of its fever, resulting in the delineation of the ideal political constitution, the Kallipolis, which recovers the virtues of the original, healthy city in an altered form. This paper develops (...) an ecological reading of the Republic, highlighting Plato’s optimism regarding humans’ ability to limit their material consumption in accordance with the limits of the natural world. The conventional interpretation of the Republic’s first city, known as ‘the city of pigs’, is reconsidered in light of new socio-ecological research on traditional resource management systems. (shrink)

For more than eleven years, I worked with Dan Callahan as an editor, a liaison with journalists, and a sounding board for ideas. To Dan, every new writing project was a thrill, whether it was for the New Republic or a blog. He consumed a wide range of professional and scholarly literature, followed the news with the eye of a reporter, and called experts when he wanted to learn more about something he had read. The result was a volcanic bubbling (...) of story ideas. If he didn't turn them into articles or books, I sometimes had the feeling that he might burst. (shrink)

Among the thousands of Hellenistic hemispherical relief bowls found on Delos is a small collection of Athenian bowls, isolated by Alfred Laumonier in the course of his work on the much larger corpus of Ionian bowls. All major decorative types are present, with long‑petal bowls in the majority. The imagery largely matches that of bowls found in Athens, but some new stamps are documented. Many fragments can be attributed to specific workshops. The fragments throw new light on the production process, (...) documenting a previously unsuspected step in that process and offering evidence for the export of molds for the production of “Attic” bowls elsewhere. Although some of the bowls arrived on the island before 167, most were imported later, and the opening of this new market may have had an impact on the development of the Athenian industry. (shrink)