Developing sustainability: A new metaphor for progress. [REVIEW]Cécile M. Bensimon &Solomon R. Benatar -2005 -Theoretical Medicine and Bioethics 27 (1):59-79.detailsIn this paper, we propose a new model for development, one that transcends the North–South dichotomy and goes beyond a narrow conception of development as an economic process. This model requires a paradigm shift toward a new metaphor that develops sustainability, rather than sustains development. We conclude by defending a ‘report card on development’ as a means for evaluating how countries perform within this new paradigm.
The role of faith-based organizations in the ethical aspects of pandemic flu planning—lessons learned from the toronto Sars experience.S. Faust Halley,M. Bensimon Cécile &E. G. Upshur Ross -2009 -Public Health Ethics 2 (1).detailsSunnybrook Health Sciences Centre, Toronto and University of Toronto Ross E. G. Upshur * Sunnybrook Health Sciences Centre, Joint Centre for Bioethics University of Toronto, Toronto * Corresponding author: Ross E. G. Upshur, Primary Care Research Unit, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #E-349, Toronto, Ontario, Canada M4N 3M5. Tel.: 416-480-4753; Fax: 416-480-4536; Email: ross.upshur{at}sunnybrook.ca ' + u + '@' + d + ' '//--> Abstract Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This (...) study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. CiteULike Connotea Del.icio.us What's this? (shrink)
Your liberty or your life: Reciprocity in the use of restrictive measures in contexts of contagion. [REVIEW]A. M. Viens,Cécile M. Bensimon &Ross E. G. Upshur -2009 -Journal of Bioethical Inquiry 6 (2):207-217.detailsIn this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing (...) and evaluating public health responses to contagion. (shrink)
The Role of Faith-Based Organizations in the Ethical Aspects of Pandemic Flu Planning--Lessons Learned from the Toronto SARS Experience.Halley S. Faust,Cécile M. Bensimon &Ross E. G. Upshur -2009 -Public Health Ethics 2 (1):105-112.detailsAre restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, (...) within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. (shrink)
On pandemics and the duty to care: whose duty? who cares?Carly Ruderman,C. Shawn Tracy,Cécile M. Bensimon,Mark Bernstein,Laura Hawryluck,Randi Z. Shaul &Ross E. G. Upshur -2006 -BMC Medical Ethics 7 (1):5.detailsBackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)
The promises and limitations of codes of medical ethics as instruments of policy change.Ana Komparic,Patrick Garon-Sayegh &Cécile M. Bensimon -2023 -Bioethics 37 (4):406-415.detailsCodes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)
What’s in a name? A discussion on the definition of natural and unnatural causes of death. [REVIEW]Wilma L. J. M. Duijst-Heesters,Koos van der Velden &Cécile M. Woudenberg-van den Broek -2022 -Philosophy, Ethics and Humanities in Medicine 17 (1):1-6.detailsAbstractWhen considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns (...) out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete. (shrink)
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Intelligent ambience between Heaven and Hell: A salvation?Cecile K. M. Crutzen -2005 -Journal of Information, Communication and Ethics in Society 3 (4):219-232.detailsQuestioning gender is about taking an active, critical role in the technological design of our daily behaviour. It is a deconstruction of the oppositions that exist in the discourses of Ambient Intelligence designers, the ICT industry and computer scientists. What underlies the assumption that Ambient Intelligence will, by disappearing into our environment, bring humans both an easy and entertaining life? The gender perspective can uncover power relations within the promotion and realisation of Ambient Intelligence that satisfy an obvious wish for (...) a technological heaven. The deconstruction of the promise of progress and a better life reveals what is overvalued, what is undervalued and what is ignored. This paper is a deconstruction of the view, currently prevalent in the discourses of Ambient Intelligence; a view of humans and the way they live. A view that will influence the way women and men will be allowed to construct their lives. (shrink)
(1 other version)Informed Consent in Direct-to-Consumer Personal Genome Testing: The Outline of A Model between Specific and Generic Consent.Eline M. Bunnik,A. Cecile J. W. Janssens &Maartje H. N. Schermer -2012 -Bioethics 28 (7):343-351.detailsBroad genome‐wide testing is increasingly finding its way to the public through the online direct‐to‐consumer marketing of so‐called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision‐making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)
Personal genome testing: Test characteristics to clarify the discourse on ethical, legal and societal issues.Eline M. Bunnik,Maartje H. N. Schermer &A. Cecile J. W. Janssens -2011 -BMC Medical Ethics 12 (1):11.detailsBackground: As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously (...) for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics.DiscussionThis paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal utility.'SummaryConsideration of test characteristics is essential to any valuable discourse on the ELSI of personal genome testing for multifactorial diseases. Four key characteristics of the test - targeted/non-targeted testing, analytical validity, clinical validity and clinical utility - together determine the applicability and the relevance of ELSI to specific tests. The paper identifies and discusses four areas of interest for the ELSI-debate on personal genome testing: informational problems, risks, regulatory issues, and the notion of personal utility. (shrink)
Obligations in a global health emergency - Authors’ reply.Ezekiel Emanuel,Cecile Fabre,Lisa M. Herzog,Ole F. Norheim,Govind Persad,G. Owen Schaefer &Kok-Chor Tan -2021 -Lancet 398 (10316):2072.detailsIn response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.
An ethical framework for global vaccine allocation.Ezekiel J. Emanuel,Govind Persad,Adam Kern,Allen E. Buchanan,Cecile Fabre,Daniel Halliday,Joseph Heath,Lisa M. Herzog,R. J. Leland,Ephrem T. Lemango,Florencia Luna,Matthew McCoy,Ole F. Norheim,Trygve Ottersen,G. Owen Schaefer,Kok-Chor Tan,Christopher Heath Wellman,Jonathan Wolff &Henry S. Richardson -2020 -Science 1:DOI: 10.1126/science.abe2803.detailsIn this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)
Possible Qualification Pathways for In Silico Methodologies.Marco Viceconti,Alexandre Serigado,Cécile F. Rousseau &Emmanuelle M. Voisin -2024 - In Marco Viceconti & Luca Emili,Toward Good Simulation Practice: Best Practices for the Use of Computational Modelling and Simulation in the Regulatory Process of Biomedical Products. Springer Nature Switzerland. pp. 67-72.detailsRegulatory science is ultimately a matter of trust. You need to trust that certain evidence, when obtained with certain methodologies, is sufficient to inform about a new medical product's safety and/or efficacy.
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Design of a Participatory Organizational-Level Work Stress Prevention Approach in Primary Education.Maartje C. Bakhuys Roozeboom,Irene M. W. Niks,Roosmarijn M. C. Schelvis,Noortje M. Wiezer &Cécile R. L. Boot -2022 -Frontiers in Psychology 13.detailsBackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)
Philosophy, Poetry, History. An Anthology of Essays. [REVIEW]J. V. M. -1968 -Review of Metaphysics 21 (3):548-549.detailsThis is certainly one of the most beautiful books in philosophy published in the last couple of years. It comprises eighty-four essays, carefully selected, well-translated, covering almost the full range of Croce's immense literary production. Croce is certainly one of the most important and influential thinkers of this century and in this huge anthology the English-speaking reader is given an incomparable instrument to get acquainted with him. The list of the headings which classify the eighty-four essays are: The Logic of (...) Philosophy; Philosophical Criticism; Aesthetics; The Philosophy of Art and Language; The Theory of History; Economics and Ethics; Essays in Criticism and Literary History; Moral and Political History. But first one should read the lateCecil Sprigge's excellent introduction.—M. J. V. (shrink)
Multiculturalism and Moral Conflict.Maria Dimova-Cookson &Peter M. R. Stirk (eds.) -2009 - Routledge.detailsMulticulturalism is higher on the daily political agenda than it has ever been. Leading politicians and public commentators speak with an unparalleled bluntness about the perceived limitations of multiculturalism while representatives of cultural, minorities express concern about marginalisation. This debate is taking place against a background of fear about terrorism, the integrity of national identities and a loosely construed ‘clash of civilizations’. Secularism is pitted against religious fundamentalism, respect for difference against the right of freedom of speech, integration against self-determination, (...) and duties of citizenship against minority rights. This book confronts the reality of moral conflict in the debate on multiculturalism while resisting the simplification which too frequently accompanies daily commentary on both sides of an increasingly polarised debate. The volume as a whole marks an important step in the attempt to examine the underlying concepts, of the nature and legitimate extent of disagreement, of secularism, the nature of power, the state and citizenship, which inevitably constitute key assumptions in the debate. Bringing together leading scholars on multiculturalism: Gerald Gaus, Peter Jones, John Horton, Tariq Modood, Chandran Kukathas, Bhikhu Parekh, Matthew Festenstein and Cecile Laborde, this book discusses the latest developments in the field. It will be of strong interest students and scholars of multiculturalism, political science, political theory, international relations, sociology, philosophy and anthropology. (shrink)
Muriel Andrin, Stéphanie Loriaux & Barbara Ost (dir.), M comme mère, M comme monstre.Annik Houel -2019 -Clio 50.detailsEnfin un ouvrage au titre radical sur cette question, publié sous les auspices du centre de recherches SAGES (savoirs, genres et sociétés) de l’Université libre de Bruxelles, suite à un colloque tenu en 2011 sur ce thème. Car si la question de la violence féminine a émergé au sein des études féministes dans les années 1990, avec notamment le livre dirigé par les historiennes Cécile Dauphin et Arlette Farge, De la violence et des femmes (1997), puis l’ouvrage collectif de Caroline (...) Cardi et Ge... (shrink)
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How It Feels: Black Screen as Negative Event in Early Cinema and 9/11 Films.Tanya Shilina-Conte -2016 -Studia Phaenomenologica 16:409-438.detailsIn this essay I engage the perspective of film phenomenology to analyze the black screen as a frame-breaking negative experience, based on an understanding of cinema as event. Relying on Vivian Sobchack’s phenomenological approach and taking inspiration fromCecil M. Hepworth’s How It Feels to Be Run Over, a case in point for a method predicated on the question of “how,” I place emphasis on the “film’s body” and consciousness which, through its own paralysis and impairment, affects the spectator’s (...) lived-body. Following the terminology of sociologist Erving Goffman, I approach both a car accident at the turn of the twentieth century and 9/11 on the cusp of the new millennium as frame-breaking events that generate a profound negative experience. I then describe the black screen in 9/11 films as a frame-breaking occurrence that creates a negative event in its own right. The encounter with the breakage of the conventional mechanisms and modes of the “film’s body” as well as the forced sensory shift lead the spectator to a heightened awareness of his/her own body as a receiving medium that empathetically partakes in the experience of a negative event at the scene of cinema, both perceptually and reflexively. (shrink)
Toward an Islamic Enlightenment: The Gülen Movement.M. Hakan Yavuz -2013 - Oup Usa.detailsM. Hakan Yavuz offers an insightful and wide-ranging study of the Gulen Movement, one of the most controversial developments in contemporary Islam. Founded in Turkey by the Muslim thinker Fethullah Gulen, the Gulen Movement aims to disseminate a ''moderate'' interpretation of Islam through faith-based education.