We are walking too quickly down the road to physical and psychological utopia without pausing to assess the potential damage to our humanity from this brave new ...

The Hungry Soul is a fascinating exploration of the natural and cultural act of eating. Kass brilliantly reveals how the various aspects of this phenomenon, and the customs, rituals, and taboos surrounding it, relate to universal and profound truths about the human animal and its deepest yearnings. "Kass is a distinguished and graceful writer. . . . It is astonishing to discover how different is our world from that of the animals, even in that which most evidently betrays (...) that we too are animals--our need and desire for food."--Roger Scruton, Times Literary Supplement "Yum."--Miss Manners. (shrink)

Broad consent – the act of gaining one consent for multiple potential future research projects – sits at the core of much current genomic research practice. Since the 25th May 2018, the General Data Protection Regulation (GDPR) has applied as valid law concerning genomic research in the EU and now occupies a dominant position in the legal landscape. Yet, the position of the GDPR concerning broad consent has recently been cause for concern in the genomic research community. Whilst the text (...) of the GDPR apparently supports the practice, recent jurisprudence contains language which is decidedly less positive. This article takes an in-depth look at the situation concerning broad consent under the GDPR and – despite the understandable concern flowing from recent jurisprudence – offers a positive outlook. This positive outlook is argued from three perspectives, each of which is significant in defining the current, and ongoing, legitimacy and utility of broad consent under the GDPR: the principled, the legal technical, and the practical. (shrink)

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they (...) are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a “bottom-up” perspective might give healthcare personnel opportunities to think and reflect more than a “top-down” perspective. A “bottom-up” approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a “top-down” approach risks removing such moral responsibility. (shrink)

BackgroundMoral case deliberation is one form of clinical ethics support, and there seems to be different ways of facilitating the dialogue.PurposeThis paper aimed to explore Swedish facilitators' experiences of their role in moral case deliberations.MethodThis study had a qualitative approach with explorative design. Semi-structured interviews with eleven MCD facilitators were conducted. Their experiences were analyzed using thematic analysis.ResultBeing a facilitator was understood through the metaphor of sailing: against the wind or with it. The role was likened to a sailor's set (...) of skills: to promote security and well-being of the crew, to help crew navigate their moral reflections, to sail a course into the wind against homogeneity, to accommodate the crew's needs and just sail with the wind, and to steer towards a harbour with authority and expertise. Balancing the disparate roles of being accommodative and challenging may create a free space for emotions and ideas, including self-reflection and con... (shrink)

Consciousness-based education and Maharishi Vedic science -- Consciousness-based education and education -- Consciousness-based education and physiology and health -- Consciousness-based education and physics -- Consciousness-based education and mathematics -- Consciousness-based education and literature -- Consciousness-based education and art -- Consciousness-based education and management -- Consciousness-based education and government -- Consciousness-based education and computer science -- Consciousness-based education and sustainability -- Consciousness-based education and world peace.

Little Vast Rooms of Undoing explores the relationship between identity and embodiment in public toilet spaces.

The purpose of this article was to examine the historical contribution of Wilhelm Dilthey's approach to the philosophy and methodology of hermeneutics in the demarcated context of nursing science. Dilthey's work made a fundamentally significant, yet ancillary, contribution to nursing science. Organically born from a need to deduce Biblical texts, hermeneutics later developed as a means to understand the truth of another's experience, in literal German language referred to as verstehen. A German‐born empiricist and devout hermeneutic scholar, Dilthey extended the (...) philosophy of hermeneutics to a methodological approach as a way to recapture expressed meaning of human experiences. His directive work paved a procedural pathway to probe the science of human nature while bound to the appropriate sociohistorical context. Hermeneutic methodology provides a phenomenological‐like way to more keenly understand and interpret the whole person. This methodological approach steers a truth‐seeking strategy fixed in meticulous and rigorous inquiry. Dilthey transparently recognized the humble fact that there is no true way to wholly grasp another's experience, an inherent limitation of our human abilities. The current paper posits that hermeneutical understanding verstehen can be paralleled to the concept of empathy in nursing. Understanding and empathy are foundational components to the field of nursing as a caring science. The complex yet invaluable philosophy and methodology of Wilhelm Dilthey's hermeneutics is notably relevant and applicable to nursing science as we strive to care for, treat, and heal patients as whole beings. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

In this age of multiculturalism, global travel and terrorism, it is vital that citizens be inculcated with the fundamental values of democracy and equipped with the cognitive skills to further those values. Plato critiqued the democratic character for its potential selfishness and lack of civic engagement---this was true in ancient Athens and is still true today. Using a primarily philosophical but also an interdisciplinary approach, I discuss the historic and social contexts of moral education in democracies both ancient and modern. (...) My topic contributes to this inquiry about democratic education by discussing Virtue Ethics and Communitarianism, with attention to empirical matters as dealt with in Sociology and Psychology. This dissertation explores the Neutral Liberalism-Communitarian debate about moral education to explicate current social and educational circumstances, both theoretically and practically. I propose a model for teaching morality based on self-knowledge, without a traditional religious grounding, without competing with religious authority, resorting to dogma, or indoctrination. I draw on the works of Plato, Aristotle, Jean-Jacques Rousseau, William James, Charles Taylor and others, supporting my proposals with current research from Social Cognitive Psychology. Research in Psychology has shown that some ways of thinking about the self are more efficacious and functional than others. By grounding moral education in self-knowledge and virtue theory, we can ensure the preservation of our democracy by improving the ability of our citizens to reason well about personal, practical and political matters. (shrink)

Philosophers and other thinkers have pondered tough questions about the nature of reality for thousands of years. Now, science seems to be discovering increasing support for this ancient concept, and Star Trek's holodeck technology offers great insights into understanding both old and new theories about what's real. The accumulation of data over the last twenty‐five years from a variety of scientific fields reveals that the reality seems to be holographic in nature. On the holodeck, there are two types of people: (...) players, like Data pretending to be Henry V or Sherlock Holmes, and non‐player characters (NPCs), holographic people created to interact with the players. Traditional mystical approaches offer the examples of prophets, saints, and saviors as similar to these holocharacters, with some traditions even providing teachings and techniques for individuals who seek to overcome their own holoprogramming. (shrink)

One thread of abortion criticism, arguing that gender equality requires that men be allowed to terminate legal parental status and obligations, has reinforced the stereotype of men as uninterested in fatherhood. As courts facing disputes over stored pre-embryos weigh the equities of allowing implantation of the pre-embryos, this same gender stereotype has been increasingly incorporated into a legal balancing test, leading to troubling implications for ART and family law.

The article contributes to the discussion of political reasoning in general, and public reason in particular, analysed from the vantage point of comparative political theory. It aims to bring out the complexity and diversity of actual political reasoning, and it serves as a corrective to some over-simplified discussions of public reason, by defenders and critics alike. I argue that the notion of public reason can be extended to and is operative in non-liberal and religious societies, with the acknowledgment that it (...) needs to undergo a methodological metamorphosis in the process. This requires what I call multiple justificatory strategy, which allows the use of different justifications in order to respond to the plurality existing in society. However, there are certain qualifications in the use of multiple justifications. I argue that this leads to two important conclusions, that the functioning of an inclusive notion of public reason requires the strategy of multiple justifications, and it contests... (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

Like others with many interests, I found picking a major in college a bit stressful. It was a relief to discover that Stanford, where I attended, had recently developed an interdisciplinary major called Human Biology, allowing me to study many things at once. "HumBio" had four main requirements: a year of coursework in biology, integrated with a year of social science core courses; a self-designed "area of concentration"; an internship; and a public policy course on either health or the environment. (...) In the years since I graduated, options for areas of concentration have become more structured, but we had significant flexibility. My self-designed concentration was "A Feminist Approach to Public Health," something I... (shrink)

Classical work on Vedanta philosophy by Bādarāyaṇa; includes three commentaries.

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Imagine creating a reality that works for you and goes far beyond your imagination. Now you can see all that is possible by using the tools of Access Consciousness. Through Kass's experiences, you will learn about continual evolution and using the flow of energy, which includes both intuition and instinct, to create movement even when the waters around you are stagnant. The tools in this book are interchangeable and can be used in your daily life to alter your way (...) of thinking. Learn how to transform negative into positive, how to take risks to avoid predictable or undesirable futures, and how to change your point of view to create the life you desire. Be in step with the energy of change and dance to the infectious rhythm of life."--Page 4 of cover. (shrink)

In Nigeria, as in other developing countries, access to training in research ethics is limited, due to weak social, economic, and health infrastructure. The project described in this article was designed to develop the capacity of academic staff of the College of Medicine, University of Ibadan, Nigeria to conduct ethically acceptable research involving human participants.

Wilson and Kass talked about their book, The ethics of human cloning, which is about the ethical debate over human cloning.

This article focuses on whether a certain form of consent used by biobanks – open consent – is compatible with the Proposed Data Protection Regulation. In an open consent procedure, the biobank requests consent once from the data subject for all future research uses of genetic material and data. However, as biobanks process personal data, they must comply with data protection law. Data protection law is currently undergoing reform. The Proposed Data Protection Regulation is the culmination of this reform and, (...) if voted into law, will constitute a new legal framework for biobanking. The Regulation puts strict conditions on consent – in particular relating to information which must be given to the data subject. It seems clear that open consent cannot meet these requirements. 4 categories of information cannot be provided with adequate specificity: purpose, recipient, possible third country transfers, data collected. However, whilst open consent cannot meet the formal requirements laid out by the Regulation, this is not to say that these requirements are substantially undebateable. Two arguments could be put forward suggesting the applicable consent requirements should be rethought. First, from policy documents regarding the drafting process, it seems that the informational requirements in the Regulation are so strict in order to protect the data subject from risks inherent in the use of the consent mechanism in a certain context – exemplified by the online context. There are substantial differences between this context and the biobanking context. Arguably, a consent transaction in the biobanking does not present the same type of risk to the data subject. If the risks are different, then perhaps there are also grounds for a reconsideration of consent requirements? Second, an argument can be made that the legislator drafted the Regulation based on certain assumptions as to the nature of ‘data’. The authors argue that these assumptions are difficult to apply to genetic data and accordingly a different approach to consent might be preferable. Such an approach might be more open consent friendly. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

As interest in comparative effectiveness research grows, questions have emerged regarding whether it is ever acceptable to alter informed consent requirements for research when patients are randomly assigned to widely-used therapies. This paper reports on interviews with Institutional Review Board members and researchers and on focus groups with patients from Geisinger and Johns Hopkins health systems. The objective was to elicit participants' views of the acceptability of four different disclosure and authorization models for low-risk pragmatic comparative effectiveness trials of widely-used (...) therapies. Results suggest that although participants valued autonomous choice, many also believed that it was acceptable to streamline information disclosure and to use an opt-out process for eligible individuals who would prefer not to participate. This provides some preliminary evidence that relevant stakeholders find alternatives to traditional informed consent acceptable for low-risk pragmatic comparative effectiveness trials of widely-used therapies as long as a sufficient amount of choice is preserved. (shrink)

Public health ethics in the future will be distinguished from public health ethics in the past by this new subfield being labeled as such, acknowledged, and called upon for service. Ethical dilemmas have been present throughout the history of public health. The question of whether to force Henning Jacobson to be immunized in 1905 in accordance with the 1902 Massachusetts smallpox vaccination law was one of ethics as well as law. How Thomas Parran, Surgeon General in 1936, chose to respond (...) to a raging syphilis epidemic in the United States in the early part of the 2W century raised considerable moral debate in determining the appropriate public health response for a government? More recently, questions have arisen concerning the appropriate reach of government in controlling HIV banning smoking, or promoting healthy lifestyles. Debates over government infringement, morality, and justice recur throughout the history of public health. (shrink)

Research participants may not adequately understand the research in which they agree to enroll. This could be due to a myriad of factors. Such a missing link in the informed consent process contravenes the requirement for an.

As pervasive as the use of the Internet has become in the United States, a huge percentage of the world’s population has yet to ever use a telephone. It seems ironic, then, that there is a concerted effort on the part of industrialized nations to first hook up their traditionally disadvantaged citizens to the Internet and second, to hook up citizens of developing nations. This paper addresses the universal access phenomenon by considering the growth of the Internet in terms of (...) Leaver and Taker users—idioms usually associated with a culture’s interactions with its environment. Leaver cultures interact with their environment in a sustainable manner while Taker cultures produce more than they need and impose their ways upon others. The Internet is explored as a community of users, which in its current state is dominated by Takers. However, realizing the need for a more heterogeneous Internet community, this paper explores incentives for Leaver cultures to assimilate online and methods of improving interface designs to be more intuitive to Leaver communities. It is hoped that a tragedy of the commons of Internet resources can be avoided as more Leavers participate in the sustainment of the Internet as a valuable tool for all communities. (shrink)

Background: The importance of respecting patients and participants in clinical research is widely recognised. However, what it means to respect persons beyond recognising them as autonomous is unclear, and little is known about what patients find to be respectful. Objective: To understand patients’ conceptions of respect and what it means to be respected by medical providers. Design: Qualitative study from an academic cardiology clinic, using semistructured interviews with 18 survivors of sudden cardiac death. Results: Patients believed that respecting persons incorporates (...) the following major elements: empathy, care, autonomy, provision of information, recognition of individuality, dignity and attention to needs. Conclusions: Making patients feel respected, or valued as a person, is a multi-faceted task that involves more than recognising autonomy. While patients’ views of respect do not determine what respect means, these patients expressed important intuitions that may be of substantial conceptual relevance. (shrink)

Book reviewed in this article: Toward a More Natural Science: Biology and Human Affairs. By Leon R. Kass.