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The removal of controversial names and monuments from the public sphere in the United States has gained traction in the context of efforts to achieve social justice for historically mistreated and marginalized communities. Such debates are increasingly raising issues in the healthcare setting as hospitals and medical schools grapple with the legacies of figures whose scientific contributions are clouded with ethical transgressions. Present efforts to address these challenges have largely occurred at the institutional level. The results have been guidelines that are complex, highly inconsistent across institutions, and largely downplay the symbolic importance of such historical redress. This paper proposes a simpler three-part test for name and monument removal in the medical and hospital settings that places greater weight on the symbolic importance of the renaming process itself instead of only considering the outcomes.
The purpose of this article is to show that animal rights are not necessarily at odds with the use of animals for research. If animals hold basic moral rights similar to those of humans, then we should consequently extend the ethical requirements guiding research with humans to research with animals. The article spells out how this can be done in practice by applying the seven requirements for ethical research with humans proposed by Ezekiel Emanuel, David Wendler, and Christine Grady to animal research. These requirements are (1) social value, (2) scientific validity, (3) independent review, (4) fair subject selection, (5) favorable risk–benefit ratio, (6) informed consent, and (7) respect for research subjects. In practice, this means that we must reform the practice of animal research to make it more similar to research with humans, rather than completely abolish the former. Indeed, if we ban animal research altogether, then we would also deprive animals of its potential benefits—which would be ethically problematic.
Teaching healthcare ethics at the doctoral level presents a particular challenge. Ethics is often taught to medical students, but rarely is medicine taught to graduate students in health care ethics. In this paper, Medicine for Ethicists [MfE] — a course taught both didactically and experientially — is described. Eight former MfE students were independently interviewed in a semi-structured, open-ended format regarding their experience in the experiential component of the course. Themes included concrete elements about the course, elements related to the broader PhD student learning experience, and themes related to the students’ past and future career experiences. Findings are related to the educational philosophy of John Dewey and David Kolb’s experiential learning theory. Broader implications of this work are explored.
How should we respond to patients who do not wish to take on the responsibility and burdens of making decisions about their own care? In this paper, we argue that existing models of decision-making in modern healthcare are ill-equipped to cope with such patients and should be supplemented by an “appointed fiduciary” model where decision-making authority is formally transferred to a medical professional. Healthcare decisions are often complex and for patients can come at time of vulnerability. While this does not undermine their capacity, it can be excessively burdensome. Most existing models of decision-making mandate that patients with capacity must retain ultimate responsibility for decisions. An appointed fiduciary model provides a formalized mechanism through which those few patients who wish to defer responsibility can hand over decision-making authority. By providing a formal structure for deferring to an appointed fiduciary, the confusions and risks of the informal transfers that can occur in practice are avoided. Finally, we note how appropriate governance and law can provide safeguards against risks to the welfare of patients and medical professionals.
Euthanasia and physician-assisted suicide are common practice in the Netherlands. In response to increasing requests from patients to end their lives, physicians are finding themselves placed in particularly precarious situations because of advance directives written by patients suffering from severe dementia. In April 2020, the Supreme Court of the Netherlands issued two judgments in the so-called Dormicum case: a case involving the deliberate termination of the life of a 74-year-old woman suffering from advanced dementia by a geriatrician in a nursing home in The Hague. The judgment of the lower criminal court was upheld, but the sanction imposed by the appellate disciplinary court was quashed. In this paper, the author reviews the two Supreme Court rulings, argues that both are fundamentally flawed and raises questions as to what they mean for Dutch criminal law, physicians, and patients going forward.
This history of a statement attributed to the developmental biologist Lewis Wolpert exemplifies the making and uses of quotations in recent science. Wolpert's dictum, ‘It is not birth, marriage or death, but gastrulation which is truly the most important time in your life’, was produced in a series of international shifts of medium and scale. It originated in his vivid declaration in conversation with a non-specialist at a workshop dinner, gained its canonical form in a colleague's monograph, and was amplified as a quotation on a poster derived from an undergraduate project. Although it drew on Wolpert's authority and he accepted his authorship, it thus represents a collective sifting of earlier claims for the significance of prenatal existence through the values of 1980s developmental biology. Juxtaposing a technical term with major life events has let teachers engage students, and researchers entice journalists, while sharing an in-joke that came to mark community identity. Serious applications include arguing for an extension of the fourteen-day limit on human-embryo research. On this evidence, quotations have been kept busy addressing every audience of specialized knowledge.
In this article, I explore how the twin forces of imperial and entomological power allowed Britain to shape locust research and control across Africa, the Middle East and South Asia from the 1920s to the early 1950s. Imperial power came from the size of the formal and informal empire, and alliances with other colonial powers to tackle a common threat to agriculture and trade. Entomological authority came primarily from the work of Boris Uvarov and his small team of museum and fieldworkers based at the Imperial Bureau of Entomology (IBE), later the Imperial Institute of Entomology (IIE). I begin by discussing how Uvarov's phase theory of the origin of swarming changed the prospects for the control of locust plagues. The imperial gaze and networks of the IBE and IIE were suited to a problem that was transnational and transcontinental. In the 1930s, Britain was drawn into plans for international cooperation on locust organizations that met the needs of science, to give better sharing of knowledge, and the needs for science, to secure the resources for research and control. However, such organizations were only created during the Second World War, when new plagues threatened military operations, as I show in relation to the measures taken to control the red locust and desert locust. In the final section, I follow the fate of the wartime cooperation in initiatives to establish permanent control organizations. It is a story of the decline of British political power in locust affairs as the United Nations Food and Agriculture Organization and regional agencies took over. My account of British locust research and control reveals a neglected aspect of histories of entomology and imperial/colonial science, especially their international relations and the continuing importance of metropolitan research centres.
This article addresses ethical concerns with the use of electronic health records (EHRs) by physicians in clinical practice. It presents arguments for two claims. First, requiring physicians to maintain patient EHRs for medically unnecessary tasks is likely contributing to increased burnout, decreased quality of care, and potential risks to patient safety. Second, medical institutions have ethical reasons to employ medical scribes to maintain patient EHRs. Finally, this article reviews central objections to employing medical scribes and provides responses to each.
Urban political ecology (UPE) provides an appropriate framework to consider the ways in which natural elements and concepts of nature have been incorporated into built environments, because of its emphasis on and elaboration of the concept of socio-natures and its focus on how the costs and benefits of these natural elements are apportioned between people of different classes in cities. This article considers how reformers’ ideas about nature shaped the kinds of social housing they developed in nineteenth- and early twentieth-century London.
This paper investigates the mythological wall paintings decorating the room known as the tablinum in atrium houses at Pompeii and Herculaneum. Scholars have considered the tablinum part of the “public” section of the house and have linked this room to the formal morning greeting, or salutatio, despite the fact that no ancient literary source mentions the tablinum in connection with this daily ritual. These assumptions have conditioned the way in which scholars have interpreted the decoration, which is analyzed in relation to the social activities supposedly associated with this type of room or discussed in terms of moral ideals and social values. This study demonstrates that the figurative imagery within the tablinum does not necessarily relate to social practices in that space but instead informs us about a common visual vocabulary shared by different strata of society.
This article makes the counterintuitive argument that the millennia-old approach of Jewish law to regulating surveillance, protecting communications, and governing collection and use of information offers important frameworks for protecting privacy in an age of big data and pervasive surveillance. The modern approach to privacy has not succeeded. Notions of individual “rights to be let alone” and “informational self-determination” offer little defense against rampant data collection and aggregation. The substantive promise of a “fundamental human right” of privacy has largely been reduced to illusory procedural safeguards of “notice” and “consent”—manipulable protections by which individuals “agree” to privacy terms with little understanding of the bargain and little power to opt out. Judaism, on the other hand, views privacy as a societal obligation and employs categorical behavioral and architectural mandates that bind all of society's members. It limits waiver of these rules and rejects both technological capacity and the related notion of “expectations” as determinants of privacy's content. It assumes the absence of anonymity and does not depend on the confidentiality of information or behavior, whether knowledge is later used or shared, or whether the privacy subject can show concrete personal harm. When certain types of sensitive information are publicly known or cannot help but be visible, Jewish law still provides rules against their use. Jewish law offers a language that can guide policy debates. It suggests a move from individual control over information as the mechanism for shaping privacy's meaning and enforcement, to a regime of substantive obligations—personal and organizational—to protect privacy. It recognizes the interconnected nature of human interests and comprehends the totality of the harm that pervasive surveillance wreaks on individuals and social relations. It offers a conceptual basis for extending traditional privacy protections to online spaces and new data uses. And it provides a language of dignity that recognizes unequal bargaining power, rejects the aggregation and use of information to create confining personal narratives and judgments, and demands equal protection for all humans.
Adams argues that the traditional doctrine of eternal hellish experience stretches the Problem of Evil beyond any reasonable solution, as hell is stubbornly incompatible with God's omnipotence, omniscience, and perfect goodness. Buckareff and Plug argue that people could leave hell. Matheson responds that if people could leave hell, people could leave heaven. But Matheson provides reasons to think that this is not possible. Luck attempts to refute Matheson's argument. I show that Luck's attempt contains analogies that lack features that crucially depict the asymmetrical relationship between heaven and hell. I advance some other analogies that I think contain such features.
This article explores refugee occupation in Delhi during the aftermath of the Partition in 1947. The temporary occupation of public buildings and open spaces was integral to the difficult and gradual assimilation of hundreds of thousands of refugees into and through the city. Monuments, shrines, mosques and temples provided temporary shelter for refugees and some remained occupied for years after the Partition. The definition and custody of these buildings speaks of the uncertainty and anxiety produced by violence and displacement in 1947 and 1948. The article considers both the modification of these places by the refugees who lived in them, and the gradual and faltering processes of eviction and the restoration of the buildings. The physical imprints of refugee occupation are a significant part of the city's past; a heritage which both marked a rupture in the city's history and reflects broader mores of urban dynamics.
This paper examines two moments in the globalization of human genetics, focusing on the American University of Beirut as a site of interaction between American, European and Middle Eastern scientific actors and research subjects. In the interwar period, the establishment of clinical laboratories at AUB's medical school enabled the development of an informal large-scale programme to study human heredity through anthropometry and sero-anthropology. AUB's Middle Eastern students were trained in these techniques, and research results were disseminated locally in Arabic as well as in international scientific journals. In the post-war period, new technologies transformed human genetics into an internationally coordinated science with specialized laboratories. However, an attempt to establish such a lab at AUB during the 1960s ended in failure: the Anthropological Blood Grouping Laboratory functioned for only four years before closing. The American and British personalities who promoted the ABGL in Lebanon aimed to collect blood samples from across the region without committing to long-term relationships with local scientists and research subjects. As an ‘outpost’ for Western scientists, the ABGL embodied the neo-colonial structure of post-war human population genetics, both in its unfulfilled aspirations to serve metropolitan research agendas and in its marginalization of Middle Eastern scientists.