In this paper, I defend the agent/patient distinction against critics who argue that causal interactions are symmetrical. Specifically, I argue that there is a widespread type of causal interaction between distinct entities, resulting in a type of ontological asymmetry that provides principled grounds for distinguishing agents from patients. The type of interaction where the asymmetry is found is when one of the entities undergoes a change in kind, structure, powers, or intrinsic properties as a result of the interaction while the (...) other does not. Interactions of this type are widespread in molecular biology and chemistry. I focus specifically on (i) the actions of enzymes on substrates and (ii) water molecules breaking the bonds of polarized molecules. Finally, I respond to objections by laying out and to a limited extent defending three commitments of my account: emergent entities and powers, realism about chemical kinds or structures, and the assumption of the agent/patient distinction in functional attributions in biology. (shrink)

While there has been significant discussion in the health sciences and ethics literatures about problems associated with publication practices (e.g., ghost- and gift-authorship, conflicts of interest), there has been relatively little practical guidance developed to help researchers determine how they should fairly allocate credit for multi-authored publications. Fair allocation of credit requires that participating authors be acknowledged for their contribution and responsibilities, but it is not obvious what contributions should warrant authorship, nor who should be responsible for the quality and (...) content of the scientific research findings presented in a publication. In this paper, we review arguments presented in the ethics and health science literatures, and the policies or guidelines proposed by learned societies and journals, in order to explore the link between author contribution and responsibility in multi-author multidisciplinary health science publications. We then critically examine the various procedures used in the field to help researchers fairly allocate authorship. (shrink)

Stephen Davies taught philosophy at the University of Auckland, Auckland, New Zealand. His research specialty is the philosophy of art. He is a former President of the American Society for Aesthetics. His books include Definitions of Art (Cornell UP, 1991), Musical Meaning and Expression (Cornell UP, 1994), Musical Works and Performances (Clarendon, 2001), Themes in the Philosophy of Music (OUP, 2003), Philosophical Perspectives on Art (OUP, 2007), Musical Understandings and Other Essays on the Philosophy of Music (OUP, 2011), The (...) Artful Species: Aesthetics, Art, and Evolution (OUP, 2012), The Philosophy of Art (Wiley-Blackwell, 2016 second ed.), and Adornment: What Self-decorations Tells Us about Who We Are, (Bloomsbury Academic, 2020). (shrink)

Some pejoratives are slurs—they target people on the basis of protected characteristics. Other pejoratives are what we can call “cognitive-behavioural pejoratives”: they target contemptible conduct or character, not protected characteristics. These two classes of pejoratives are semantically similar, yet the ethical profiles of their use are radically different. There is an Estonian pejorative that targets people on the basis of a mixture of ethnicity (approximately: Russian) and a cognitive-behavioural trait (approximately: chauvinism). What is the ethical status of the use of (...) such a word: a word that combines properties of ethically very different pejoratives? This paper draws upon interviews with members of the ethnic group that the word’s usage is associated with, and members of the ethnic group targeted by the word, to better understand the laudability and criticizability of various some uses of the pejorative. We defend the view that the pejorative had some plausibly laudable uses during the period when Estonia was annexed by Soviet Russia, and that (even these) uses of the pejorative are in principle susceptible to faults that, when they arise, make use of the word criticizable. (shrink)

In ‘The Pregnancy Rescue Case: why abortion is immoral’, Hendricks presents The Pregnancy Rescue Case. In this reply I argue that even if it would be better (i.e., less bad) for the abortion to be prevented in The Pregnancy Rescue Case, that does not mean that typical abortions are impermissible. I also argue that there is a possible explanation, consistent with the pro-choice view and empirically testable, as to why people would think it better for the abortion to be prevented (...) in The Pregnancy Rescue Case. (shrink)

Context-sensitive expressions appear ill suited to the purpose of sharing content across contexts. Yet we regularly use them to that end (in regulations, textbooks, memos, guidelines, laws, minutes, etc.). This paper describes the utility of the concept of a metacontext for understanding cross-contextual content-sharing with context-sensitive expressions. A metacontext is the context of a group of contexts: an infrastructure that can channel non-linguistic incentives on content ascription so as to homogenize the content ascribed to context-sensitive expressions in each context in (...) the group. Documents composed of context-sensitive expressions can share content across contexts when supported by an appropriate metacontext. The bible has its church, the textbook its education system, the form its bureaucracy, and the manifesto its social movement. Some metacontexts support cross-contextual content-sharing. Some don’t. A promising research programme (one with practical importance) would take metacontexts as its unit of analysis. (shrink)

There is a widely acknowledged shortage of and an increasing demand for transplantable human organs and tissues (e.g., kidney, heart, lung, liver, cornea) in developed and developing countries around the world. In response to this need, Lott and Savulescu (2007) propose the creation of a human embryonic stem (hESC) bank to facilitate the equitable and efficient dissemination of human leukocyte anti- gen (HLA) matched tissues and organs to patients in need of replacement. Although not an unreasonable proposal, the authors go (...) on to make a much stronger claim. They argue that hESCs are such important tools for addressing the massive unmet global need for organs that it is ethically justified to require mandatory banking of spare embryos, and they argue for the use of financial (or other) inducements to procure embryos for the derivation of hESCs. (shrink)

According to telling based views of testimony (TBVs), B has reason to believe that p when A tells B that p because A thereby takes public responsibility for B's subsequent belief that p. Andrew Peet presents a new argument against TBVs. He argues that insofar as A uses context-sensitive expressions to express p, A doesn't take public responsibility for B's belief that p. Since context-sensitivity is widespread, the kind of reason TBVs say we have to believe what we're told, is (...) not widespread. Peet doesn't identify any problem with his own argument though he does attempt to limit its sceptical potential by identifying special contexts in which TBVs stand a chance of success. A more general defence of TBVs can be provided by showing Peet's argument to be unsound. I argue that Peet's argument is unsound because it requires us to wrongly suppose that speakers do far less labour than their audiences in context-sensitive linguistic communication. I aim to show why—in the context of the epistemology of testimony and the philosophy of language—it's important to recognize the labour that speakers can do, and so can can be held responsible for not doing, in episodes of context-sensitive linguistic communication. (shrink)

While there is considerable disagreement on the precise nature of material objecthood, it is standardly assumed that material objects must be spatial. In this paper, I provide two arguments against this assumption. The first argument is made from largely a priori considerations about modal plenitude. The possibility of non-spatial material objects follows from commitment to certain plausible principles governing material objecthood and plausible principles regarding modal plenitude. The second argument draws from current philosophical discussions regarding theories of quantum gravity and (...) the emergence of spacetime. When it is appreciated what possible worlds these current theories commit us to, the possibility of non-spatial material objects will follow. Thus, either route will lead us to the possibility of non-spatial material objects. The significance of this result is that we need to revise our accounts of material objecthood to both accommodate these possibilities and the theories that lead to them. (shrink)

In this paper we explore the idea that Pentecostalism is best supported by conjoining it to a postmodern, narrative epistemology in which everything is a text requiring interpretation. On this view, truth doesn’t consist in a set of uninterpreted facts that make the claims of Christianity true; rather, as James K. A. Smith says, truth emerges when there is a “fit” or proportionality between the Christian story and one’s affective and emotional life. We argue that Pentecostals should reject this account (...) of truth, since it leads to either a self-refuting story-relativism or the equally problematic fallacy of story-ism: favoring one’s own story over others without legitimate reason. In either case, we contend, the gospel itself is placed at risk. (shrink)

Lee (2017) calls for greater attention to the shared epistemological and normative grounds of both public health ethics and environmental ethics, and to Potter’s original conception of bioethics, which, as she rightly observes, has been largely disregarded in contemporary North American bioethics scholarship and practice. In a previous publication we also argued in favor of reviving the Potterian approach to bioethics; we built a case grounded in “the relatively new field of molecular epigenetics [that] provides novel information that should serve (...) as additional justification for expanding the scope of bioethics to include environmental and public health concerns.”. (shrink)

Healthcare practitioners have access to a range of ethical guidance. However, the normative role of this guidance in ethical decision-making is underexplored. This paper considers two ways that healthcare practitioners could approach ethics guidance. We first outline the idea of deference to ethics guidance, showing how an attitude of deference raises three key problems: moral value; moral understanding; and moral error. Drawing on philosophical literature, we then advocate an alternative framing of ethics guidance as a form of moral testimony by (...) colleagues and suggest that a more promising attitude to ethics guidance is to approach it in the spirit of ‘critical engagement’ rather than deference. (shrink)

Utilitarianism has an apparent pedigree when it comes to animal welfare. It supports the view that animal welfare matters just as much as human welfare. And many utilitarians support and oppose various practices in line with more mainstream concern over animal welfare, such as that we should not kill animals for food or other uses, and that we ought not to torture animals for fun. This relationship has come under tension from many directions. The aim of this article is to (...) add further considerations in support of that tension. I suggest three ways in which utilitarianism comes significantly apart from mainstream concerns with animal welfare. First, utilitarianism opposes animal cruelty only when it offers an inefficient ratio of pleasure to pain; while this may be true of eating animal products, it is not obviously true of other abuses. Second, utilitarianism faces a familiar problem of the inefficacy of individual decisions; I consider a common response to this worry, and offer further concerns. Finally, the common utilitarian argument against animal cruelty ignores various pleasures that humans may get from the superior status that a structure supporting exploitation confers. (shrink)

Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.

Estonian doesn't have a definite article. Instead, bare singular noun phrases can unambiguously bear either a definite interpretation or an indefinite interpretation. This paper argues that the pragmatic principles governing the felicitous use of three English articles ("a", "the" and "another"), described by A Grønn and KJ Sæbø (2012, 'A, the, another: A game of same and different' Journal of Logic, Language and Information 21, 75-95) can also account for the conditions under which a bare singular noun phrase in Estonian (...) bears a definite or instead an indefinite interpretation. The two languages use the same pragmatic principles to determine the definiteness interpretation of a noun phrase. The difference is just that in English (where definiteness meanings have been lexicalized) these pragmatic principles govern the felicity of article use, whereas in Estonian they govern the interpretation of a bare singular noun phrase. (shrink)

This paper outlines new work in cross-cultural psychology largely drawn from Nisbett, Choi, and Smith (Cognition, 65, 15–32, 1997); Nisbett, Peng, Choi, & Norenzayan, Psychological Review, 108(2), 291–310, 2001; Nisbett, The Geography of Thought: How Asians and Westerners Think Differently...and Why. New York: Free Press 2003), Ji, Zhang and Nisbett (Journal of Personality and Social Psychology, 87(1), 57–65, 2004), Norenzayan (2000) and Peng (Naive Dialecticism and its Effects on Reasoning and Judgement about Contradiction. University of Michigan, Ann Arbor, Michigan 1997) (...) Peng and Nisbett (Cross-Cultural Similarities and Differences in the Understanding of Physical Causality. Paper presented at the Science and Culture: Proceedings of the Seventh Interdisciplinary Conference on Science and Culture, Frankfort, K. Y. 1996), and Peng, Ames, & Knowles (Culture and Human Inference: Perspectives from three traditions. In: D. Matsumoto (Ed.), Handbook of Cross-Cultural Psychology (pp. 1–2). Oxford: Oxford University Press 2000). The paper argues that the findings on cultural influences on inference-making have implications for teaching and education generally, and specifically for the debate on conceptions and misconceptions of Asian students studying in western tertiary institutions around the world. The position defended is that, while there seems to be compelling empirical evidence for intercultural differences in thought patterns, these patterns are, for the most part, insignificant in everyday exchanges, though language and culture might subtlety modulate our inference-making at the margins. Linguistic determinism however is not defended. Nonetheless, the evidence provides food for thought, and it needs to inform the recent debates about international students studying overseas. (shrink)

Many people feel that respecting a person’s autonomy is not sufficiently important to obligate us to stay out of their affairs in all cases; but the ground for interference may often turn out to be a hunch that the agent cannot really be competent, or cannot really know what her decision implies; for if she were both of these things, surely she would not make such a foolish decision. This paper suggests a justification of paternalism that does not rely on (...) such appeals. I argue that in cases where an agent will undergo a significant alteration in their evaluative outlook – ‘evaluative shift’ – three central, persuasive objections to paternalism lose their force, and offer a prima facie case for paternalism in some of these cases. I then suggest that we can extend this argument to some cases where evaluative alteration is not predictable, but where the risk and harm are both significant. In such cases, paternalism may be justified. (shrink)

In seeking to clarify the concept of conflict of interest (COI) in debates about physician–industry relationships, Howard Brody (2011) highlights the extent to which the prob- lem turns on a common pejorative understanding of COI. Whether it is the academic or public policy “pharmapologists” or “pharmascolds” talking about COI, there is often a straightforward and overly simplistic correlation made: that is, a conflict of interest—by definition—leads to fraudulent or corrupt behavior. The same type of reasoning is com- monly found in (...) discussions about COI outside the health sciences, most notably in news stories about the awarding of government contracts or the behaviour of corporate executives. The problem is that in focusing on dramatic failures to manage COI (e.g., around Vioxx), there is a tendency to strongly associate COI with extreme forms of financial and even criminal misconduct, leaving the public, policymakers, academics, and professionals with a skewed and limited understanding of the concept. (shrink)

I defend an interpretation of Aristotle’s _Posterior Analytics _Book I which distinguishes between two projects in different passages of that work: to explain what a given science is and to explain what properly scientific knowledge is. I present Aristotle’s theory in answer to ii, with special attention to his definition of scientific knowledge in 71b9-12 and showing how this is developed on chapters 1.2-9 and 1.13 into a solid Theory of Scientific Demonstration. The main point of this theory is that (...) demonstrations need to capture relevant explanations. Some formal requirements of the demonstration are unfoldings of the main project, 1.e., to capture and present properly relevant causal-explanatory relations. (shrink)

IntroductionAssociative theories of political obligation offer a fresh alternative to approaches such as social contract theory, fair play, and the natural duty of justice. Few suggestions in ethics are more intuitive than the idea that we have special obligations to our family and friends, just in virtue of our relationships with them, and it is reasonable that obligations to political society are also grounded through association.A basic question for associative theories is to explain how associations give rise to obligation, but (...) here there is a common error. Many associative theorists and their critics take this question to be equivalent to the question: what distinguishes associations that are morally acceptable from those that are not? The assumption is that associations which are morally acceptable are those that give rise to obligations. However, this assumption is wrong in two ways. Associations that have some unacceptable features may still give rise to obl .. (shrink)

Our primary aim in this paper is to sketch a cognitive evolutionary approach for developing explanations of social change that is anchored on the psychological mechanisms underlying normative cognition and the transmission of social norms. We throw the relevant features of this approach into relief by comparing it with the self-fulfilling social expectations account developed by Bicchieri and colleagues. After describing both accounts, we argue that the two approaches are largely compatible, but that the cognitive evolutionary approach is well- suited (...) to encompass much of the social expectations view, whose focus on a narrow range of norms comes at the expense of the breadth the cognitive evolutionary approach can provide. (shrink)

Analysis in English of Annalisa D. Quagliata Blanco’s experimental feature film ¡Aoquic iez in Mexico! /¡Ya México no existirá más! (2024).

The case study presented by Winch and Sinnott (2011) shows not only how difficult it is for clinicians and researchers to identify conflicts of interest (COI), but also how damaging it can be when there are unin- formed and uncoordinated policy responses by senior administrators.

Since the 1970s, there has been rapid and wide ranging development in the field of new reproductive technologies (NRT). With donor insemination (DI) and in vitro fertilization (IVF), previously infertile couples have been given new hope and the chance to have children. A more recent addition to these new methods of reproduction has been the combination of DI and IVF with surrogate mother arrangements.[1] This technique has subtly changed the realm of reproduction, for with the addition of a third party (...) (the surrogate) to the reproductive environment, the nature of motherhood, fatherhood, and the allocation of parental rights and duties has come into question.... In other words, has commercial surrogacy changed the traditional Western understanding of motherhood and does it do an injustice to the surrogate, the contracting mother, and/or women in general? I will argue that the fragmentation of the legal concept of ‘mother’ has created a range of social and ethical problems that need to be addressed; nevertheless, the basic societal definition of ‘motherhood’ remains substantially unchanged. (shrink)

« Jouer le jeu académique » est l’aboutissement de deux années de billets hebdomadaires sur le blogue BrynStorming de Bryn Williams-Jones, professeur de bioéthique à l’École de santé publique de l’Université de Montréal. -/- En tant qu’éthicien intéressé depuis longtemps par les questions de justice, Williams-Jones a été motivé par le besoin de répondre aux injustices rencontrées dans le monde universitaire. De nombreux étudiants ou chercheurs échouent dans leurs études ou dans leur progression de carrière non pas parce qu’ils (...) n’ont pas les capacités intellectuelles ou le dynamisme nécessaires, mais simplement parce qu’ils ne savent pas ce que l’on attend d’eux ou comment se présenter au mieux dans un environnement compétitif. En d’autres termes, ils ne connaissent pas « les règles du jeu, » et ce n’est pas juste, car les règles sont rarement explicites. -/- Dans ce livre, qui s’articule autour de cinq grands sections – le parcours académique; l’identité professionnelle; la vie universitaire; la productivité et la créativité; les responsabilités multiples et la santé mentale – Williams-Jones fait part de ses 30 années d’expérience dans le monde universitaire pour rendre explicites les normes et les règles souvent implicites de la vie universitaire, afin que tous ceux qui le souhaitent puissent jouer le jeu de manière équitable. (shrink)

“Playing the Academic Game” is the culmination of two years of weekly posts on the BrynStorming blog by Bryn Williams-Jones, professor of bioethics in the School of Public Health at the Université de Montréal. -/- As an ethicist long interested by questions of justice, an important motivator for this project has been Williams-Jones’ need to respond to the injustices encountered in academia. Many students and researchers fail in their studies or career progression not because they don’t have the intellectual (...) abilities or drive, but simply because they don’t know what’s expected of them or how to best present themselves in a competitive environment. That is, they don’t know “the rules of the game,” and this isn’t fair, because the rules are rarely made explicit. -/- In this book, which is organized into 5 major sections – The Academic Career Path, Professional Identity, University Life, Productivity and Creativity, and Multiple Responsibilities and Mental Health – Williams-Jones shares 30 years of experience in academia to make explicit the often-implicit norms and rules of academic life, so that all who wish to can fairly play the academic game. (shrink)

Research on research ethics—regarding both the governance and practice of the ethical review of human subjects research—has a tumultuous history in North America and Europe. Much of the academic literature focuses on issues to do with regulating the conduct and quality of ethics review of research protocols by ethics committees (research ethics boards (REBs) in Canada and institutional review boards (IRBs) in the United States). In addition, some of the literature attends to issues particular to the review of qualitative research, (...) and still other literature addresses the challenges posed by and the need for research on REBs/IRBs. It is this third group of literature within which our article is situated. (shrink)

At some point in the future – perhaps within the next few decades – it will be possible for foetuses to develop completely outside the womb. Ectogenesis, as this technology is called, raises substantial issues for the abortion debate. One such issue is that it will become possible for a woman to have an abortion, in the sense of having the foetus removed from her body, but for the foetus to be kept alive. We argue that while there is a (...) right to an abortion, there are reasons to doubt that there is a right to the death of the foetus. Our strategy in this essay is to consider and reject three arguments in favour of this latter right. The first claims that women have a right not to be biological mothers, the second that women have a right to genetic privacy, and the third that a foetus is one's property. Furthermore, we argue that it follows from rejecting the third claim that genetic parents also lack a right to the destruction of cryopreserved embryos used for in vitro fertilization. The conclusion that a woman possesses no right to the death of the foetus builds upon the claims that other pro-choice advocates, such as Judith Jarvis Thomson, have made. (shrink)

Spanish version of collaborative essay with Oaxaca-based Mexican experimental filmmaker Bruno Varela on his found footage project La máquina de futuro. Published on the website Los Experimentos together with the release of Varela's diptych Anáhuac contra los robots, consisting of the films La máquina de futuro and La ranura en el tiempo.

Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive resource (...) allocation using the values of responsibility, reciprocity, and justice. Although our aim here is not to defend a single view of vaccine-sensitive resource allocation, we believe that attending critically with the diversity of arguments in favor (and against) vaccine-sensitivity reveals a number of questions that a vaccine-sensitive approach to allocation should answer in future pandemics. (shrink)

There are conceptual and ethical challenges to defining adolescents’ autonomy to access health care, and these can lead to health care norms and practices that could be maladjusted to the needs and preferences of adolescents. Particularly sensitive is access to sexual and reproductive health care services (SRHS). Yet, while there has been substantial conceptual work to conceptualize autonomy (e.g., as independence), there is a lack of empirical research that documents the perceptions of adolescents regarding on how they access or wish (...) to access health care services. The main objectives of this research were to (a) understand how adolescents in Colombia interpret the concept of “autonomy,” (b) describe how these adolescents articulate their autonomy (i.e., preferences) in accessing SRHS, and (c) analyze the ethical issues emerging from these data. Forty-five semi-structured interviews were conducted with participants aged 14 to 23 years old in the Departments of Antioquia and Valle del Cauca in Colombia. Our study showed that participants’ understanding of autonomy was context-based and highly dependent on personal experiences, and these influenced their choice in how to access SRHS. Seen through the ethical lens of a reproductive justice framework, our results highlight the unequal opportunities for adolescents in terms of autonomy to access SRHS. (shrink)

: Decisions about funding health services are crucial to controlling costs in health care insurance plans, yet they encounter serious challenges from intellectual property protection—e.g., patents—of health care services. Using Myriad Genetics' commercial genetic susceptibility test for hereditary breast cancer (BRCA testing) in the context of the Canadian health insurance system as a case study, this paper applies concepts from social contract theory to help develop more just and rational approaches to health care decision making. Specifically, Daniels's and Sabin's "accountability (...) for reasonableness" is compared to broader notions of public consultation, demonstrating that expert assessments in specific decisions must be transparent and accountable and supplemented by public consultation. (shrink)

Spanish version of essay on the film ¡Aoquic iez in Mexico! / ¡Ya México no existirá más! (Annalisa D. Quagliata Blanco, 2024).

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

A current advance within the agricultural industry is the use of genetic engineering to produce novel crops for food production. This technology raises questions about how societies should position themselves with respect to genetically modified (GM) crop development and implementation; namely, how should the potentials and risks of this technology be evaluated? We argue that current methods to evaluate the risks and benefits of GM crops are inadequate and not conducive to the strategic development of this technology, where a way (...) to ameliorate technology assessments for GM crops is to include farmers in the research process of evaluating these crops prior to their commercialization. However, particularities concerning the ethical status of such research require special consideration and vigilance. For example, in such technology assessment initiatives, farmers would occupy both the roles of research participant and research investigator. Other particularities surface due to factors related to the nature of GM crops. These particularities are examined with reference to concepts drawn from the field of research ethics, namely informed consent, compensatory decisions, and issues of participant inclusion/exclusion. (shrink)

Dans notre société de plus en plus digitalisée, avons-nous vraiment le choix d’adopter ou non les technologies? Comment cette digitalisation impacte-t-elle les personnes âgées en particulier et son écosystème? Quels sont les enjeux éthiques soulevés par cette digitalisation? Ce texte vise à amener des éléments de réflexions en lien avec ces enjeux selon le point de vue de divers experts des domaines de la technologie, du vieillissement et de la bioéthique. Ces experts se sont rencontrés lors d’un symposium ayant eu (...) lieu à Angers, France, en octobre 2019. Le texte est un compte-rendu des échanges et points de vue de ces experts, ainsi que des discussions ouvertes qu’ils ont eues avec l’assistance, portant sur les principaux enjeux soulevés par cette digitalisation selon la perspective des personnes âgées, des proches-aidants, des soignants, de la société et de la recherche. (shrink)

Public discussions of ethical issues related to the biotechnology industry tend to treat "biotechnology" as a single, undifferentiated technology. Similarly, the pros and cons associated with this entire sector tend to get lumped together, such that individuals and groups often situate themselves as either "pro-" or "anti-" biotechnology as a whole. But different biotechnologies and their particular application context pose very different challenges for ethical corporate decision-making. Even within a single product category, different specialty products can pose strikingly different ethical (...) challenges. In this paper, we focus on the single over-arching category of "genetic testing" and compare tests for disease susceptibility and drug response. We highlight the diversity of ethical challenges - grouped under the broad categories of "truth in advertising" and "protecting intellectual property" - raised by the commercialization and marketing of these technologies. By examining social and technical differences between genetic tests, and the associated corporate ethics challenges posed by their commercialization, our intent is to contribute to the nascent business ethics literature examining issues raised by the development and marketing of genetic tests. (shrink)

Sustainability science seeks to extend scientific investigation into domains characterized by a distinct problem-solving agenda, physical and social complexity, and complex moral and ethical landscapes. In this endeavor it arguably pushes scientific investigation beyond its usual comfort zones, raising fundamental issues about how best to structure such investigation. Philosophers of science have long scrutinized the structure of science and scientific practices, and the conditions under which they operate effectively. We propose a critical engagement between sustainability scientists and philosophers of science (...) with respect to how to engage in scientific activity in these complex domains. We identify specific issues philosophers of science raise concerning current sustainability science and the contributions philosophers can make to resolving them. In conclusion we reflect on the steps philosophers of science could take to advance sustainability science. (shrink)

L’érosion actuelle de la confiance du public envers les campagnes de vaccination et les décisions de politiques publiques qui y sont associées, aggravée par des scandales comme ceux relatifs à la pandémie H1N1 et l’utilisation du Tamiflu™, risque de diminuer de façon significative l’efficacité de ces interventions importantes pour la santé publique. Un manque de confiance de la population envers les acteurs de santé publique peut conduire à une méfiance accrue face aux interventions, pouvant ainsi compromettre l’atteinte des objectifs recherchés (...) par une intervention spécifique et, conséquemment, avoir un impact important sur les bénéfices attendus pour la population visée par cette intervention. Dans la production des avis d’experts, les membres des comités consultatifs d’experts en immunisation (CCEI) peuvent avoir une influence importante sur la prise de décision publique, notamment, sur la sélection par les décideurs de santé publique de vaccins en particulier et la façon dont les campagnes de vaccination seront déployées. En contrepartie de cette influence sur les décisions publiques, une indépendance et une transparence sont attendues de leur part puisque des mécanismes de divulgation et de gestion de conflits d’intérêts (CI) imparfaits peuvent affecter négativement la confiance du public à l’égard de telles décisions. Il apparaît donc important de s’assurer que des mécanismes de gestion des CI, transparents et robustes, existent pour ces comités. Dans cette étude, les avis ou rapports d’évaluation de la pertinence de la vaccination préparés par un CCEI au Québec ont été examinés pour quatre types de maladies évitables par la vaccination (infections invasives à méningocoques et à pneumocoques, coqueluche et virus du papillome humain). Le but était de : 1) identifier les CI divulgués par les membres du CCEI dans leurs rapports comparativement à ceux déclarés dans leurs publications scientifiques pour ces mêmes infections ; 2) analyser la nature des CI (réel, potentiel, apparent, personnel, financier, institutionnel, etc.) et l’impact potentiel (risque) sur la prise de décision impartiale et sur la confiance du public ; et 3) évaluer les mécanismes de gestion de CI actuellement utilisés par ce CCEI. Les résultats de cette étude montrent que très peu de rapports du CCEI contiennent une section sur les CI par rapport à la pléthore divulguée dans les publications scientifiques publiées par les membres du CCEI. De plus, les CI divulgués dans les rapports fréquemment ne correspondent pas à ceux décrits dans les publications scientifiques. Il serait donc important d’introduire des mesures visant à accroître la transparence des experts en immunisation et d’améliorer les mécanismes de divulgation et de gestion des CI afin de veiller à ce que la confiance du public envers les décideurs en santé publique soit maintenue et améliorée. (shrink)

This article seeks to describe in general terms what has become the standard way of conceptualizing moral injury in the clinical psychological and psychiatric literature, which is the key source for applications of the concept in other domains. What we call “the standard model” draws on certain assumptions about beliefs, mental states, and emotions as well as an implicit theory of causation about how various forms of harm arise from certain experiences or “events” that violate persons’ moral beliefs and systems. (...) Our analysis makes these assumptions more explicit and subjects them to critical scrutiny. In so doing, we survey the current literature and identify basic features of how moral injuries are defined, how they are thought to occur, and the forms of treatment or repair that appear to be indicated. We caution that it matters how moral experience is characterized and argue that an alternative understanding of what is the moral in moral injury is important for overcoming critical challenges to the standard model. Moreover, recently evolving approaches to moral repair could be more consistent with an alternative model. Our concluding suggestion is that a more robust account of the nature of moral experience and its relations to self-identity and social experience more generally could advance understanding of the etiology of moral injury and promote rehabilitation. (shrink)

Genetic testing technologies are rapidly moving from the research laboratory to the market place. Very little scholarship considers the implications of private genetic testing for a public health care system such as Canada’s. It is critical to consider how and if these tests should be marketed to, and purchased by, the public. It is also imperative to evaluate the extent to which genetic tests are or should be included in Canada’s public health care system, and the impact of allowing a (...) two-tiered system for genetic testing. A series of threshold tests are presented as ways of clarifying whether a genetic test is morally appropriate, effective and safe, efficient and appropriate for public funding and whether private purchase poses special problems and requires further regulation. These thresholds also identify the research questions around which professional, public and policy debate must be sustained: What is a morally acceptable goal for genetic services? What are the appropriate benefits? What are the risks? When is it acceptable that services are not funded under health care? And how can the harms of private access be managed? (shrink)

Antimicrobial resistance is a growing public health concern and is associated with the over- or inappropriate use of antimicrobials in both humans and agriculture. While there has been reco- gnition of this problem on the part of agricultural and public health authorities, there has none- theless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and (...) the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicro- bial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethi- cal norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production. (shrink)

Imagine that you are part of the editorial board of a young bioethics journal committed to publishing open access (OA) and to ensuring accessibility to high quality and innovative scholarship. To support junior and interna- tional scholars who might not otherwise find places for their work in the leading Western bioethics journals, you do not charge author fees. Imagine also that you have no financial resources to pay for a professional website, auto- mated submissions manager, or even a part-time coordina- (...) tor: Your government has cut all grants for journals, you cannot go to industry for private funding because of the evident risk of apparent conflicts of interest, and your strapped-for-cash institution cannot afford to offer you any support. If one of the major publishers were to approach you to sign a deal, the temptation would be strong to accept. However, this would likely mean putting aside your ideals: It would be impossible to stay a “Green OA” publication (i.e., free of author publication charges) or supportive of junior and international scholars (because of pressures to “increase credibility” through artificially high rejection rates, for example). (shrink)

After six years (2012-2017) of publishing innovative bioethics scholarship, BioéthiqueOnline becomes the Canadian Journal of Bioethics/Revue canadienne de bioéthique. As executive editors of BioéthiqueOnline, we frequently heard from members of the Canadian bioethics community of the need to develop a platform with the right branding to showcase the value and the richness of our collective reflections, both locally and internationally. Following discussions with colleagues across the country, we came to the conclusion that BioéthiqueOnline had developed a unique expertise publishing bioethics (...) scholarship, but that the original name, created to convey the bilingual and open access mission of the journal, was not enthusiastically received. So the time has come to upgrade and rebrand as the Canadian Journal of Bioethics (CJB). (shrink)

In this paper, we argue that promoting patient values is a legitimate goal of medicine. Our view offers a justification for certain current practices, including birth control and living organ donation, that are widely accepted but do not fit neatly within the most common extant accounts of the goals of medicine. Moreover, we argue that recognising value promotion as a goal of medicine will expand the scope of medical practice by including some procedures that are sometimes rejected as being outside (...) the scope of acceptable medical practice, such as certain forms of physician-assisted death. We then rebut some common and possible objections to this view. Our aim is not to argue that other accounts are mistaken—except when they argue for a single goal that does not include patient values—but rather to show that value promotion should play a more central role in discussions about the goals of medicine. (shrink)

Ongoing research in the fields of genetics and biotechnology hold the promise of improved diagnosis and treatment of genetic diseases, and potentially the development of individually tailored pharmaceuticals and gene therapies. Difficulty, however, arises in determining how these services are to be evaluated and integrated equitably into public health care systems such as Canada's. The current context is one of increasing fiscal restraint on the part of governments, limited financial resources being dedicated to health care, and rising costs for new (...) health care services and technologies. This has led to increasing public debate in the last few years about how to reform public health care, and whether we should prohibit, permit or perhaps even encourage private purchase of health care services. ;In Canada, some of these concerns have crystallized around the issue of gene patents and commercial genetic testing, in particular as illustrated by the case of Myriad Genetics' patented BRACAnalysis test for hereditary breast and ovarian cancer. While most Canadians who currently access genetic services do so through the public health care system, for those with the means, private purchase is becoming an option. This situation raises serious concerns---about justice in access to health care; about continued access to safe and reliable genetic testing supported by unbiased patient information; and about the broader effects of commercialization for ongoing research and the Canadian public health care system. Commercial genetic testing presents a challenge to health care professionals, policy analysts, and academics concerned with the social, ethical and policy implications of new genetic technologies. Using the Myriad case as an exemplar, tools from moral philosophy, the social sciences, and health policy and law will be brought to bear on the larger issues of how as a society we should regulate commercial research and product development, and more coherently decide which services to cover under public health insurance and which to leave to private purchase. Generally, the thesis is concerned with the question of "how best to bring capital, morality, and knowledge into a productive and ethical relationship". (shrink)

The case of Andrew Gobea, the first child to receive experimental gene therapy for SCID, and a reflection on the associated ethical implications of gene therapy research.