Confronting ethical permissibility in animal research: rejecting a common assumption and extending a principle of justice

A common assumption in the selection of nonhuman animal subjects for research and the approval of research is that, if the risks of a procedure are too great for humans, and if there is a so-called scientific necessity, then it is permissible to use nonhuman animal subjects. I reject the common assumption as neglecting the central ethical issue of the permissibility of using nonhuman animal subjects and as being inconsistent with the principle of justice used in human subjects research ethics. This principle requires that certain classes of individuals not be subjected to a disproportionate share of the burdens or risks of research. I argue for an extension of this principle to nonhuman animal research and show that a prima facie violation of the principle occurs because nonhuman animals bear an overwhelmingly disproportionate share of the risks of research without sufficient justification or reciprocal benefit.     

When clinical care is like research: the need for review and consent

The prevailing “segregated model” for understanding clinical research sharply separates it from clinical care and subjects it to extensive regulations and guidelines. This approach is based on the fact that clinical research relies on procedures and methods—research biopsies, blinding, randomization, fixed treatment protocols, placebos—that pose risks and burdens to participants in order to collect data that might benefit all patients. Reliance on these methods raises the potential for exploitation and unfairness, and thus points to the need for independent ethical review and more extensive informed consent. In contrast, it is widely assumed that clinical care does not raise these ethical concerns because it is designed to promote the best interests of individual patients. The segregation of clinical research from clinical care has been largely effective at protecting research participants. At the same time, this approach ignores the fact that several aspects of standard clinical care, such as clinician training and scheduling, also pose some risks and burdens to present patients for the benefit of all patients. We argue that recently proposed learning health care systems offer a way to address this concern, and better protect patients, by developing integrated review and consent procedures. Specifically, current approaches base the need for independent ethical review and more extensive informed consent on whether an activity is categorized as clinical research or clinical care. An ethically sounder approach, which could be incorporated into learning health care systems, would be to base the need for independent ethical review and more extensive informed consent on the extent to which an activity poses risks to present patients for the benefit of all patients.     

Regulatory and ethical principles in research involving children and individuals with developmental disabilities

Children and individuals with developmental disabilities (DD) compared to typical participants are disadvantaged not only by virtue of being vulnerable to risks inherent in research participation but also by the higher likelihood of exclusion from research altogether. Current regulatory and ethical guidelines although necessary for their protection do not sufficiently ensure fair distributive justice. Yet, in view of disproportionately higher burdens of co-occurring physical and mental disorders in individuals with DD, they are better positioned to benefit from research by equitable participation. Greater elucidation of this ethical dilemma is called for by researchers, institutional review boards, and funding agencies to urgently redress the imbalance. This article discusses many of the regulatory principles to ensure better research participation of children and individuals with DD: human rights, validity, distributive justice, beneficence/nonmaleficence, and autonomy.     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一.通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性.     

IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So,Why and for Whom?

Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.     

Critical remarks on Rawls's burdens of judgement

I examine the role of the burdens of judgement argument in Rawls's defence of the claim that liberalism cannot be based on a comprehensive doctrine. According to Rawls, the burdens of judgement make it very unlikely that most individuals can agree on anything more than a purely political morality. I argue that the argument does not succeed. I concentrate on the last three burdens which are specifically about problems of reaching normative agreement. Firstly, I argue that Rawls's claim that modern society inevitably gives rise to a diversity of values is not convincing since for every claim of divergence a counterclaim of convergence can be provided. Secondly, I provide examples of plausible agreement on partial comprehensive doctrines. Thirdly, I argue that liberalism must rely on at least one partial comprehensive doctrine, namely, the value of autonomous choice. I conclude that the burdens of judgement argument does not demonstrate that liberalism cannot be based on comprehensive moral foundations.     

The Negotiated Allocation of Benefits and Burdens: The Impact of Outcome Valence, Contribution, and Relationship

This laboratory study investigates negotiated allocations of benefits and burdens. We compare both the distributive and integrative aspects of negotiation to determine whether benefits and burdens are allocated according to the same norms of distributive justice and how well negotiators integrate their interests. We hypothesize that the distribution of resources depends on the valence of the resources and negotiators′ relative contributions to those resources. We also expect that the efficiency of agreements depends on the valence of resources, the negotiators′ contributions, and the time horizon of their relationships. Results support the hypotheses. Equity is more commonly used to allocate burdens than benefits; agreements for allocating burdens are less integrative than those for benefits; and agreements are more efficient when relationships are long term and subjects contribute unequally to the resources being allocated than when they contribute equally or relationships are short term. We discuss these results in terms of Taylor′s (1991) hypothesis about the asymmetrical effects of positive and negative events.     

How should citizens’ collective liability for state action be grounded?

This paper assesses one type of justification for collective liability – the democratic authorization account – according to which citizens can be held liable for what their state does, because they collectively authorize the state’s actions. I argue that the democratic authorization view, properly understood, has an implausibly narrow scope, which risks leaving many victims of injustice without compensation. Hence, I propose a subsidiary account that is wider in scope, and which applies to most cases of state-inflicted harm. This view picks out liable agents on the basis of (a) their ability to bear the compensatory burdens, (b) the incentives that the prospect of liability give citizens to hold their states in check, and (c) distributive concerns. Lastly, I address the relationship between citizens who are (merely) collectively liable for some harm, and citizens who are to some extent morally responsible (for instance in virtue of having endorsed the state-inflicted harm).     

Desert,Harm Reduction,and Moral Education: The Case for a Tortfeasor Penalty

Those found liable for negligently injuring others are required to compensate them, but current practices permit most tort feasors to spread the costs of their liability burdens through the purchase of insurance. Those found guilty of criminal offences, however, are not allowed to shift the burdens of their sentences onto others. Yet the reasons for not allowing criminal offenders to shift such burdens – harm reduction, retribution, and moral education – also appear to retain some force in relation to negligent tort feasors. Arguments for and against limiting the abilities of negligent tort feasors to spread such costs, thus imposing a penalty on them, are discussed. The conclusion reached is that further consideration of such a penalty is warranted. This revised version was published online in August 2006 with corrections to the Cover Date.     

Implementing climate equity: the case of Europe

For over two decades, international environmental equity – the fair and just sharing of the burdens associated with environmental changes – has been the subject of much debate by philosophers, activists and diplomats concerned about climate change. It has been manifested in many international environmental agreements, notably the Framework Convention on Climate Change and the Kyoto Protocol. The question arises as to whether it is being put into practice in this context. Are the requirements of international environmental equity merely words and principles in international instruments, or are they having a practical effect on the policies of state governments? This article aims to start answering these questions. It examines whether the European Union (EU) and its member states are sharing the burdens of climate change. The article introduces equity in the context of the climate change agreements and looks at some normative and practical considerations. It suggests that Europe has been a leader on international equity in the climate change negotiations over the last decade, and it points to what European states and the EU have done to take on some of the burdens of climate change. Europe's actions are briefly assessed from practical and normative perspectives. Europe is doing more than any other part of the world to address climate change and to share the burdens associated with it. Nevertheless, Europe is not doing as much to address this problem as it can and should do. Both practical and normative imperatives demand more urgent action by Europe to implement climate equity.     

Saving the worst for last: The effect of time horizon on the efficiency of negotiating benefits and burdens

Three experiments explored the effect of outcome delays—longer time horizons for the realization of outcomes—on the efficiency of negotiated agreements. We hypothesized that there would be a positive relationship between a longer temporal distance to the consequences of negotiated agreements and the efficiency of those agreements. Outcome delays did increase the efficiency of the negotiated agreements. In addition, type of resource, burden or benefit, moderated this relationship. Because negotiating for burdens is more difficult than negotiating for benefits in the present, the salutary discounting effects of outcome delays were greater for burdens. The multifaceted effects of time on negotiations are discussed.     

Student Evaluations and Gendered Expectations: What We Can't Count Can Hurt Us

Does teacher's gender impact students' evaluations? We critically evaluated the research literature and concluded that the form gender bias takes may not be easily detectible by quantitative scales. To explore this possibility, we did a qualitative analysis of the words that 288 college students at two campuses used to describe their best- and worst-ever teachers. Although we found considerable overlap in the ways that students talked about their male and female teachers, we also saw indications that students hold teachers accountable to certain gendered expectations. These expectations place burdens on all teachers, but the burdens on women are more labor-intensive. We also saw signs of much greater hostility toward women than toward men who do not meet students' gendered expectations.     

PALME

Background

Single mothers and their children are exposed to increased psychosocial burdens and risks. Nevertheless, in Germany offers of help especially designed for the needs of this group are lacking.

Method

An emotion-oriented parental training program (PALME, http://www.palme-elterntraining.de) based on the attachment theory was developed particularly for single mothers with preschool children. The training is guided by trained kindergarten nurses. The effectiveness of the parental training program on the measure of maternal psychological impairment, emotional competence and child problem behavior was investigated within a randomized, controlled study with 61 single mothers suffering from medium grade psychosocial impairment.

Results

Analyses of variance revealed significant group×time interaction effects in favor of the intervention group compared to controls. After the training the mothers showed improvement in their psychological impairment, depression and emotional competence. In addition, evidence suggests that behavioral problems of the children were reduced.

Conclusion

In view of the benefits of this parental training and its low costs it should be recommended as a regular offer of support for single mothers within community settings.     

To grandmother's house we go? Around the bend on the “mommy track”

This paper focuses on caregiving issues and their salience for women as the primary providers of care to elderly relatives. Assignment to caregiving roles on the basis of gender reflects cultural values and has important social, psychological, and economic implications. Advances in biomedical technology are changing the nature and duration of women's traditional responsibilities for elder care, and present trends suggest that long-term care concerns will continue to gain in prominence as the American population ages. Socialization processes and demographic factors impose greater caregiving burdens on women than on men. A resurgence of interest in family responsibility for elder care, arising out of growing public concern over rapidly rising costs, also affects women disproportionately. The greatest danger is that serial caregiving will compound and reinforce women's current disadvantages in the labor market. Policies that move toward more equitable distribution of caregiving burdens are clearly overdue.     

Lead and hyperactivity: Lead levels among hyperactive children

Previous work has demonstrated an association between hyperactivity and increased body lead burdens in school-age children. In the present study it is shown that within a group of hyperactive children those for whom an organic etiology is present have lead burdens lower than in those for whom no apparent cause could be found. These data lead us to reject the notion that hyperactivity per se is responsible for the acquisition of elevated lead levels, and further strengthen the suspicion that for some children lower lead level absorption may be implicated in the development of the hyperkinetic disorder.This work was supported in part by the Office of Child Development, Grant #OCD-CB482. We thank Dr. Bernard Davidow for blood and urine determinations done by the Bureau of Laboratories, Lead Poison Division, Public Health Service, New York City. We also wish to thank Merck, Sharpe and Dohme for supplying the penicillamine for this study.     

从动物权利的讨论看道德的交互性本质

道德的交互性是人类道德生活的基本特征之一。有关动物权利的讨论能为我们清楚地揭示出这一点。它主要指向收益和负担之间的某种程度的均衡,对人类的道德实践提出了真正的挑战。     

Justice and Game Advantage in Sporting Games

This paper is a case study of what Jon Elster calls "local justice"; particular schemes of justice which, on a relatively autonomous basis, are designed and implemented by institutions and practices to meet particular preferences and goals. The paper suggests an interpretation of the role of justice in sporting games. First, a framework for examinations of schemes of local justice is suggested. Second, norms are suggested that express the requirements that have to be met in order to consider a sporting game as just. The discussion shows that sports are characterized by a particular blend of meritocratic justice in which goods and burdens are distributed according to performance, and a non-meritocratic distribution through which goods and burdens arise as matters of chance. The essay concludes by arguing that the optimal blend of meritocratic justice and chance results in the realization of not merely fair sporting games, but of exciting and good games as well.     

The psychology of markets vs. hierarchies: The procedural fairness of alternative allocation procedures for benefits and burdens

This paper reports two studies examining the influence of social context on judgments about the fairness and desirability of two allocation mechanisms — markets and hierarchies. Two allocation contexts are compared: distributing benefits and burdens. The results show that people prefer to allocate burdens through markets and benefits through hierarchies. In both cases desirability is linked to procedural fairness, suggesting that people always prefer to use the fairer procedure for allocation, but view different procedures as fairer in these different contexts. Procedural fairness judgments were found to be linked to respondents' judgments about the impact of using different procedures to make allocations in each context, with people in each case preferring the procedure that they believe will have the most positive impact upon group cohesion. These findings suggest that what is construed as a fair procedure in one social context is not the same as what is construed as a fair procedure in another social context.     

How to Fail in Private Practice: 13 Easy Steps

Because the many burdens of establishing and maintaining a private practice can sometimes feel heavy, this article is offered as a catalyst for lightening up a bit. Having learned from making some form of each of these 13 mistakes, the author humbly presents them to readers with tongue in cheek.     

Counseling Patients with Senile Dementia of the Alzheimer Type and Their Families

Within the field of gerontology, senile dementia of the Alzheimer type has been noted as an area in which the family does not receive much support, although the emotional burdens are tremendous. This article offers client-centered counseling techniques for the Alzheimer Disease patient and examines the benefits of group or individual counseling for the family.