First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

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.

Human beings are strange animals. Although evolutionary theory has brilliantly accounted for the features we share with other creatures—from the genetic code that directs the construction of our bodies to the details of how our muscles and neurons work—we still stand out in countless ways. Our brains are exceptionally large, we alone have truly grammatical language, and we alone compose symphonies, drive cars, eat spaghetti with a fork and wonder about the origins of the universe.

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)

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)

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)

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)

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: 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)

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)

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)

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)

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)

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)

The Mind Doesn’t Work That Way is an expose of certain theoretical problems in cognitive science, and in particular, problems that concern the Classical Computational Theory of Mind (CTM). The problems that Fodor worries plague CTM divide into two kinds, and both purport to show that the success of cognitive science will likely be limited to the modules. The first sort of problem concerns what Fodor has called “global properties”; features that a mental sentence has which depend on how the (...) sentence interacts with a larger plan (i.e., set of sentences), rather than the type identity of the sentence alone. The second problem concerns what many have called, “The Relevance Problem”: the problem of whether and how humans determine what is relevant in a computational manner. However, I argue that the problem that Fodor believes global properties pose for CTM is a non-problem, and that further, while the relevance problem is a serious research issue, it does not justify the grim view that cognitive science, and CTM in particular, will likely fail to explain cognition. (shrink)

Through our hands we construct our world and through our construction of our world we construct ourselves. We reach with our hands and touch with our hands, and with this reaching and touching we come to understand how things feel and are. It is not an utterable knowledge, yet it is knowing the world in a dynamically-engaged affective, effective way. Through affective feedback our reaching and touching becomes a prehensive grasping which leads, through the enkinaesthetic givenness of the agent with (...) its world, to a situated and embodied knowing, and the rudiments of apprehension. With each fresh comprehension a new enkinaesthetic enquiry is engendered; with each enquiry we have afresh the anticipatory dynamics of reaching, touching and feeling, with the hand-to-object of world-investigation, the hand-to-body of auto-investigation and investigating the Other. (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)

To say that man is made up of strength and weakness, pettiness and grandeur, is not to draw up an indictment against him: it is to define him.Denis Diderot Introduction Not long ago, I was startled to read in my morning paper that legislators in North Carolina were nearing consensus on how to compensate roughly 3,000 people who had been involuntarily sterilized under the state’s eugenics laws – the first of which was enacted in 1919, and the most recent of (...) which wasn’t repealed until 2003. Un... (shrink)

In this essay, I suggest that significant insights of recent feminist philosophy lead, among other things, to the thought that it is not always better to choose than to be compelled to do what one might have done otherwise. However, few feminists, if any, would defend such a suggestion. I ask why it is difficult to consider certain ideas that, while challenging in theory, are, nonetheless, rather unproblematic in practice. I suggest that some questions are not pursued seriously enough by (...) philosophers, because certain popular liberal conceptions of individuality and freedom are taken too much for granted. (shrink)

Kristina Rolin (2002), in her article in Social Epistemology, asks the question, “Is ‘the social’ a feminist insight?” Rolin then goes on to examine this observation further in the context of femin...