As with other areas of the social world, academic research in the contemporary healthcare setting has undergone adaptation and change. For example, research methods are increasingly incorporating citizen participation in the research process, and there has been an increase in collaborative research that brings academic and industry partners together. There have been numerous positive outcomes associated with both of these growing methodological and collaborative processes; nonetheless, both bring with them ethical considerations that require careful thought and attention. This paper addresses (...) the ethical considerations that research teams must consider when using participatory methods and/or when working with industry and outlines a novel informed consent matrix designed to maintain the high ethical standard to which academic research in the healthcare arena has traditionally adhered. (shrink)

In a challenge trial, research subjects are purposefully exposed to some pathogen in a controlled setting, in order to test the efficacy of a vaccine or other experimental treatment. This is an example of medical effective altruism (MEA), where individuals volunteer to risk harms for the public good. Many bioethicists rejected challenge trials in the context of Covid‐19 vaccine research on ethical grounds. After considering various grounds of this objection, I conclude that the crucial question is how much harm research (...) subjects can permissibly risk. But we lack a satisfying way of making this judgment that does not appeal simply to the intuitions of doctors or bioethicists. I consider one recent and structurally plausible approach to critically evaluating the harm question. Alex London defends a social consistency test for research risks: we should compare the risks undertaken by research subjects to relevantly similar risks which are accepted in other spheres of society. I argue there is no good reason not to consider volunteer military service as a relevant social comparison. This implies there is essentially no cap on acceptable risks on the social consistency rationale. In short, if soldiers can be heroes, why can't research volunteers? (shrink)

Value conservatism is the thesis that there is a distinctive reason to preserve valuable things even when a (somewhat) more valuable thing might be created by their destruction. I offer an account that improves on the current literature in response to Cohen's “Rescuing Conservatism.” In short, we become psychologically attached to valuable things that make up part of our lives; the same holds true, interestingly, with things of relatively neutral value. Severing attachments is painful. This yields a reason to favor (...) an object that someone is attached to over an object that no one is attached to. But an analysis is only part of a theory of conservatism: we also need to know whether such conservatism is justified. I argue that Cohen's idea of “accepting the given” can be read to yield such a justification: it is valuable to maintain some moderate disposition to accept what one already has. This attachment‐based account of conservatism displays a number of attractive theoretical features, including accounting for the impulse to restore past valuables and providing a framework for judging conservatism excessive. (shrink)

Intuitively we feel that we ought to (attempt) to save the lives, or ameliorate the suffering, of identifiableIdentifiable individuals where we can (Rulli and Millum, 2016, p. 261). But this comes at a price. It means that there may not be any resources to save the lives of others in similar situations in the future. Or worse, there may not be enough resources left to prevent others from ending up in similar situations in the future. This chapter asks whether this (...) is justifiable or whether we would be better served focusing on public health in the form of preventative medicine. It looks briefly at the supposed difference between benefiting individuals and benefiting populations by considering the difference between interventions aimed at ‘rescue’ and those which are preventative. It then considers the rule of rescueRule of rescue in the health care setting, and looks at some of the reasons stemming from this that we might have for allocating resources to rescue interventions. If these reasons do not provide adequate justification for preferring these types of interventions, then the implication is that our current mode of resource allocation may need to be revised in favour of a more public health-oriented model. (shrink)

How should the law deal with the challenges of advancing biotechnology? This book is a philosophical and legal re-analysis.

In the United Kingdom, the debate about how best to meet the shortfall of organs for transplantation has persisted on and off for many years. It is often presumed that the answer is simply to alter the law to a system of presumed consent. Acting perhaps on that presumption in his annual report launched in July, the Chief Medical Officer, Sir Liam Donaldson, advocated a system of organ donation based on presumed consent, the so-called “opt-out” system.1 He is calling for (...) a change in the law in England and Wales whereby consent to organ donation is presumed, making a person’s organs automatically available for transplantation after death, unless they registered objections to this while alive. Subsequently, the British Medical Association lent its support to the introduction of such a system.2 The BMA contends that “the practice of presumed consent legislation has had a significant effect on the number of cadaveric donors per million population.”2It is often taken for granted that there must be a correlation between the enactment of legislation on presumed consent and an increase in organ donation and procurement. However, the correlation is not as straightforward as it might seem. It may be that other practical measures to encourage organ donation could be implemented without changing the Human Tissue Act 2004, an Act which has been in force for barely a year.An analysis by Abadie and Gay demonstrated that “presumed consent legislation has a positive and sizeable effect on organ donation rates”,3 but they themselves admitted that the correlation between rates of donation and presumed consent legislation is “not completely unequivocal”.3 It is true that among the most successful cases in procurement rates are countries with presumed consent legislation . However, since some of the …. (shrink)

Following the publication of the Weatherall report on the use of non-human primates in research, this paper reflects on how to provide appropriate and ethical models for research beneficial to humankind. Two of the main justifications for the use of non-human primates in biomedical research are analysed. These are the “least-harm/greatest-good” argument and the “capacity” argument. This paper argues that these are equally applicable when considering whether humans are appropriate subjects of biomedical research.

This paper argues that the new commercial and quasi-commercial activities of medicine, scientists, pharmaceutical companies and industry with regard to human tissue has given rise to a whole new way of valuing our bodies. It is argued that a property framework may be an effective and constructive method of exploring issues arising from this. The paper refers to A M Honoré’s theory of ownership and aims to show that we have full liberal ownership of our own bodies and as such (...) can be considered to be self-owners. (shrink)

Yet another medical ethics book has been published, but the difference this time is that I actually like it Sokol and Bergson’s handbook Medical ethics and law—surviving on the wards and passing exams is for medical students and junior doctors preparing for life in medicine and for the inevitable exams. The format of the book closely follows that of the core curriculum for medical ethics and law set out by the BMA in 2004 in Medical ethics today. The book ….

There have been calls for some time for a new approach to public health in the United Kingdom and beyond. This is consequent on the recognition and acceptance that health problems often have a complex and multi-faceted aetiology. At the same time, policies which utilise insights from research in behavioural economics and psychology have gained prominence on the political agenda. The relationship between the social determinants of health and behavioural science in health policy has not hitherto been explored. Given the (...) on-going presence of strategies based on findings from behavioural science in policy-making on the political agenda, an examination of this is warranted. This paper begins by looking at the place of the SDoH within public health, before outlining, in brief, the recent drive towards utilising behavioural science to formulate law and public policy. We then examine the relationship between this and the SDoH. We argue that behavioural public health policy is, to a certain extent, blind to the social and other determinants of health. In section three, we examine ways in which such policies may perpetuate and/or exacerbate health inequities and social injustices. We argue that problems in this respect may be compounded by assumptions and practices which are built into some behavioural science methodologies. We also argue that incremental individual gains may not be enough. As such, population-level measures are sometimes necessary. In section four we defend this contention, arguing that an equitable and justifiable public health requires such measures. (shrink)

Vocal music and spoken language both have important roles in human communication, but it is unclear why these two different modes of vocal communication exist. Although similar, speech and song differ in certain design features. One interesting difference is in the pitch intonation contour, which consists of discrete tones in song, vs. gliding intonation contours in speech. Here, we investigated whether vocal phrases consisting of discrete pitches (song-like) or gliding pitches (speech-like) are remembered better, conducting three studies implementing auditory same-different (...) tasks at three levels of difficulty. We tested two hypotheses: that discrete pitch contours aid auditory memory, independent of musical experience (“song memory advantage hypothesis”), or that the higher everyday experience perceiving and producing speech make speech intonation easier to remember (“experience advantage hypothesis”). We used closely matched stimuli, controlling for rhythm and timbre, and we included a stimulus intermediate between song-like and speech-like pitch contours (with partially gliding and partially discrete pitches). We also assessed participants' musicality to evaluate experience-dependent effects. We found that song-like vocal phrases are remembered better than speech-like vocal phrases, and that intermediate vocal phrases evoked a similar advantage to song-like vocal phrases. Participants with more musical experience were better in remembering all three types of vocal phrases. The precise roles of absolute and relative pitch perception and the influence of top-down vs. bottom-up processing should be clarified in future studies. However, our results suggest that one potential reason for the emergence of discrete pitch–a feature that characterises music across cultures–might be that it enhances auditory memory. (shrink)

Joseph Raz’s service conception of law remains one of the best known theories of political authority. Setting aside ongoing debates about the nature of authority, I locate a problem in the basic justificatory structure of the service conception. I show that the service justification of the state does not yield the conclusion that the law generates exclusionary reasons, which are meant to be the key hallmark of authority. An automatic but defeasible _habit _of obeying the state is likely to lead (...) to better outcomes than exclusionary deference to the state. Given the instrumental justification of the service conception, this means that exclusionary reasons to defer do not obtain. Habituation and automaticity have been developed in other contexts and are here extended to the context of political authority. The possibility of habitual obedience undercuts Raz's theory while suggesting a new approach to the question of political authority. (shrink)

An increasing portion of contemporary politics revolves around a set of claims made by those (typically derisively) referred to as NIMBYs. Despite its practical significance, NIMBYism has not received significant attention in academic philosophy. I attempt a charitable but limited reconstruction of NIMBYism in terms of legitimate expectations. I argue that, despite NIMBY expectations being somewhat vague and at least moderately unjust, they may be legitimate. This does not imply that they are decisive, or entail a conclusion about their overall (...) normative force. I close by developing some tentative details in institutional design, focusing on the possibility of monetary compensation as a way of recognizing, but limiting the force of, NIMBY expectations. (shrink)

ABSTRACTHow should we conceive of a right to reproduce? And, morally speaking, what might be said to justify such a right? These are just two questions of interest that are raised by the technologies of assisted reproduction. This paper analyses the possible legitimate grounds for a right to reproduce within the two main theories of rights; interest theory and choice theory.

“You must go on. I can’t go on. I’ll go on.” These are some of the most quoted lines written by Samuel Beckett, which speak to the impulse of persevering in times of crisis and impossibility. Yet few readers of Beckett agree about what this paradoxical formula could mean, let alone what mode of engagement it would seem to indicate, be it committed, autonomous, or something else entirely. This volume of essays explores what that mode of engagement could be, all (...) the while elucidating the ethical and political stakes of the “ongoing” in both Beckett’s life and work. Across multiple disciplines in the humanities, the authors delve into questions of political subjectivity and representation, the ethics of powerlessness and refusal, the aesthetics of syncopation and destitution, multimedia experiments between genre, as well as Beckett’s wider impact on transnational itineraries of modernism and philosophy up to the contemporary. (shrink)

In this article we address the question of how many impossible images Escher produced. To answer requires us first to clarify a range of concepts, including content, ambiguity, illusion, and impossibility. We then consider, and reject, several candidates for impossibility before settling on an answer.

Organizational leaders are increasingly emphasizing a stakeholder perspective in order to address concerns about business ethics. This study examined the choices of 94 groups in the context of a business decision-making simulation to determine how specific actions and communications can facilitate the consideration of different stakeholder perspectives. In particular, we examined whether generally framing the business situation as one involving diverse stakeholders versus a primarily profit-driven operation (referred to as framing), and whether specific suggestions that participants consider the concerns of (...) stakeholders versus stockholders in maximizing the value of the firm (referred to as vision priming), would influence group choices and decision outcomes. We tested four experimental conditions against a control in a 2 × 2 experimental design to determine the effects that group choices had on decision outcomes when groups were exposed to stakeholder versus stockholder decision framing and stakeholder versus stockholder vision priming. The results revealed that the consistent conditions outperformed the control condition and that vision priming has a greater impact on decision outcomes than decision framing. (shrink)

Research ethics principles and regulations typically have been applied to the protection of individual human subjects. Yet, new paradigms of research that include the place-based community and cultural groups as partners or participants of environmental research interventions, in particular, require attention to place-based identities and geographical contexts. This paper argues the importance of respecting “place” within human subjects protections applied to communities and cultural groups as part of a critical need for research ethics and cultural competence training for graduate research (...) students. These protections and benefits are extensions of the Belmont Principles and have been included in recent recommendations from research regulatory committees. (shrink)

Recent ethical and legal challenges have arisen concerning the rights of individuals over their IVF embryos, leading to questions about how, when the wishes of parents regarding their embryos conflict, such situations ought to be resolved. A notion commonly invoked in relation to frozen embryo disputes is that of reproductive rights: a right to have (or not to have) children. This has sometimes been interpreted to mean a right to have, or not to have, one's own genetic children. But can (...) such rights legitimately be asserted to give rise to claims over embryos? We examine the question of property in genetic material as applied to gametes and embryos, and whether rights over genetic information extend to grant control over IVF embryos. In particular we consider the purported right not to have one's own genetically related children from a property-based perspective. We argue that even if we concede that such (property) rights do exist, those rights become limited in scope and application upon engaging in reproduction. We want to show that once an IVF embryo is created for the purpose of reproduction, any right not to have genetically-related children that may be based in property rights over genetic information is ceded. There is thus no right to prevent one's IVF embryos from being brought to birth on the basis of a right to avoid having one's own genetic children. Although there may be reproductive rights over gametes and embryos, these are not grounded in genetic information. (shrink)

Among global environments, the undersea is unique in the challenges it poses - and the opportunities it affords - for sensation, perception, inquiry, and imagination. The Aesthetics of the Undersea charts a history of the subaqueous in Western culture, from the early modern period to the present.

Previous research has found that depression is characterised by biased processing of emotional information. Although most studies have examined cognitive biases in isolation, simultaneous examination of multiple biases is required to understand how they may interact and influence one another to produce depression vulnerability. In this study, the attention and memory biases of currently depressed, previously depressed, and never depressed women were examined using the same stimuli and a unified methodology. Participants viewed negative, positive, and neutral words while their eye (...) gaze was tracked and recorded. After a distraction task, participants completed an incidental recognition test that included words from the eye-tracking task and new words. The results supported the hypothesised mediation model for positive words: currently depressed women had a reduced attention bias for positive words and, in turn, had poorer memory for positive words relative to never depressed women. Previously depressed women, however, showed a lack of coherence between attention and memory biases for positive words. The groups did not differ in their attention or memory biases for negative words. The findings provide novel evidence in support of a causal link between the absence of protective attention and memory biases for positive information in clinical depression. (shrink)

Governments and policy-makers have of late displayed renewed attention to behavioural research in an attempt to achieve a range of policy goals, including health promotion. In particular, approaches which could be labelled as ‘nudges’ have gained traction with policy-makers. A range of objections to nudging have been raised in the literature. These include claims that nudges undermine autonomy and liberty, may lead to a decrease in responsibility in decision-making, lack transparency, involve deception, and involve manipulation, potentially occasioning coercion. In this (...) article I focus on claims of coercion, examining nudges within two of the main approaches to coercion—the pressure approach and the more recent enforcement approach. I argue that coercion entails an element of control over the behaviour of agents which is not plausibly displayed by the kinds of serious examples of nudges posited in the literature. (shrink)

Researchers of the Northeast Ethics Education Partnership at Brown University sought to improve an understanding of the ethical challenges of field researchers with place-based communities in environmental studies/sciences and environmental health by disseminating a questionnaire which requested information about their ethical approaches to these researched communities. NEEP faculty sought to gain actual field guidance to improve research ethics and cultural competence training for graduate students and faculty in environmental sciences/studies. Some aspects of the ethical challenges in field studies are not (...) well-covered in the literature. More training and information resources are needed on the bioethical challenges in environmental field research relating to maximizing benefits/reducing risks to local inhabitants and ecosystems from research; appropriate and effective group consent and individual consent processes for many diverse communities in the United States and abroad; and justice considerations of ensuring fair benefits and protections against exploitation through community-based approaches, and cultural appropriateness and competence in researcher relationships. (shrink)

In this paper we call for attention to be paid to the link between logic and geometry. To apply this theme, we survey the connection between n-cubes, Lukasiewicz logics and Ulam games. We then extend what is known to the case where the number of permitted lies in a Ulam game exceeds 1. We conclude by identifying the precise sense in which these logics are paraconsistent.

In this article, an argument is made for extending bioethical principles to place-based community and cultural group protections when there are conflicting perspectives on reporting individual results of biomonitoring studies. Bioethical principles of beneficence, nonmaleficence, respect for autonomy, and justice can incorporate participatory decision-making and understandings of the group conditions of individual research participants, particularly for research studies with vulnerable groups. Arguments for and against biomonitoring communication to individual participants are reviewed here. Assessments of risks and benefits of biomonitoring communication (...) can be improved by considering the contextual conditions of cultural groups and place-based communities. Providing participatory decision-making with all stakeholders about biomonitoring communication can provide more fair benefits than adopting a general, prescriptive clinical standard that favors only group report-backs when clinical utility is low and the scientific understandings of low dose exposures of chemical contaminants to humans are still uncertain. (shrink)

Individual research protections provided by bioethical principles can be extended to group protections, particularly for place-based communities and cultural groups who may share a common harm or burden. In this article, an argument is made for the need to consider the group conditions of individual research subjects in the ethics of individual report-backs of human biomonitoring results. Human biomonitoring, the measuring of concentration of chemicals or their metabolites in blood, urine, breast milk, hair, and other biological samples, can provide an (...) assessment of an individual's exposure to a chemical and can integrate exposures from multiple pathways and sources. Biomonitoring studies have been increasing in the past decade for such purposes as measuring the levels of chemicals that are ingested by members of the general population and at what concentrations, to determine if exposure levels are higher in some groups vs. others, to track temporal trends to establish reference ranges for chemical exposures, and to investigate an association with health. (shrink)

Firms’ real estate choices significantly affect their sustainability, due to real estate’s impact on the natural environment. This paper investigates the ecological responsiveness of firms in specific industries by analyzing the decisions these firms make in occupying office space. We analyze the decisions of more than 11,000 tenants to choose office space in green buildings or in, otherwise comparable, conventional buildings nearby. Controlling for building quality and location, we find that corporations in the oil and banking industries, as well as (...) non-profit organizations, are among the most prominent green tenants. Furthermore, measures of an industry’s human capital intensity are positively related to the propensity to lease green office space. These empirical findings confirm the theoretical framework on economic advantage and institutional pressure as important determinants for the ecological responsiveness of firms. (shrink)

Modernist Fiction and Vagueness marries the artistic and philosophical versions of vagueness, linking the development of literary modernism to changes in philosophy. This book argues that the problem of vagueness - language's unavoidable imprecision - led to transformations in both fiction and philosophy in the early twentieth century. Both twentieth-century philosophers and their literary counterparts were fascinated by the vagueness of words and the dream of creating a perfectly precise language. Building on recent interest in the connections between analytic philosophy, (...) pragmatism, and modern literature, Modernist Fiction and Vagueness demonstrates that vagueness should be read not as an artistic problem but as a defining quality of modernist fiction. (shrink)

A response is given to the claim by Claxton and Culyer, who stated that the policies of the National Institute for Health and Clinical Excellence (NICE) do not evaluate patients rather than treatments. The argument is made that the use of values such as quality of life and life-years is ethically dubious when used to choose which patients ought to receive treatments in the National Health Service (NHS).

Jonathan Haidt's research on moral cognition has revealed that political liberals moralize mostly in terms of Harm and Fairness, whereas conservatives moralize in terms of those plus loyalty to Ingroup, respect for Authority, and Purity. Some have concluded that the norms of morality encompass a wide variety of subject matters with no deep unity. To the contrary, I argue that the conservative position is partially debunked by its own lights. IAP norms’ moral relevance depends on their tendency to promote welfare. (...) I argue that all moral agents, including conservatives, are committed to that claim at least implicitly. I then argue that an evolutionary account of moral cognition partially debunks the view that welfare-irrelevant IAP norms have moral force. Haidt's own normative commitments are harmonized by this view: IAP norms are more important than liberals often realize, yet morality is at bottom all about promoting welfare. (shrink)

The primary aim of this article is to point up an essential attitude, an anxiety even, that has inflected – and perhaps inhibited - our engagement with film. Film theory has been marked by a ‘refusal to see, a looking away’ (Mulvey & Wollen 1976, 36), and my suggestion is that this has achieved its fullest expression in those strands of film theory heavily influenced by psychoanalysis. These, in turn, have remained within a gendered conceptual framework whereby the discursive or (...) the narrative is associated with the masculine, and the image or spectacle is aligned with the feminine. This is not to reject these applications out of hand but rather to revisit this area with its blind spots in mind and to consider aspects that are perhaps at once obvious but often overlooked. (shrink)

I argue that with the advent of poststructuralism, traditional theories of representation, truth, and resistance have been seriously brought into question. References to the “natural” and the “wild” cannot escape the poststructural attack against foundational concepts and the constituting character of human-centered language. I explore the ways in which environmental movements and literary expression have tended to posit pre-ideological essences, thereby replicating patterns of power and authority. I also point to how environmentalism might be reshaped in light of poststructuralism to (...) challenge power without reference to authority. (shrink)

The traditional ‘no property’ approach of the law to human biomaterials has long been punctured by exceptions. Developments in the jurisprudence of property in human tissue in English law and beyond demonstrate that a variety of tissues are capable of being subject to proprietary considerations. Further, among commentators, there are few who would deny, given biotechnological advances, that such materials can be considered thus. Yet, where commentators do admit human biomaterials into the realm of property, it is often done with (...) an emphasis on some sort of separation from the person who is the source of those materials. One line of argument suggests that there is a difference between persons and things, which constitutes a morally justifiable distinction when it comes to property. This article examines whether the idea of separability can do the work of demarcating those objects that ought to be considered property from those that ought not to be. It argues that, despite the entailment of a separability criterion inherent in both the statutory and common law positions, and the support given to this by some commentators, it is philosophically problematic as the basis for delineating property in human tissue and other biomaterials. (shrink)

Petersen and Lippert-Rasmussen argue that, while a tax credit scheme to encourage organ donation would be costly, the increased number of organs for transplantation would lead to other savings in the healthcare system. In the present work some calculations are provided and it is suggested that, even given optimistic assumptions, the cost to the state of implementing the system as proposed would be high and unlikely to garner the support of politicians and policymakers.

Ross, Hintikka, Waterlow and Makin have all suggested that there is something problematic about Aristotle’s treatment of possibility. I will canvas their concerns and propose that the problem is not so much with Aristotle as the fact that the notion of possibility is not a single simple concept. I will present eight different components of the notion of possibility and suggest that Aristotle may have been aware of all of them. I will conclude whilst his treatment can appear inconsistent, it (...) is instead, an attempt to give a complete description of a complex notion. (shrink)

In this paper I will describe four theories of time that can be found in Aristotle. I will compare these four theories with modern notions of time, and propose that the ancient and modern views are substantively the same. Of course, all four theories cannot be true together. I will present four ways to resolve the inconsistencies, and conclude that the contradictions can be resolved.