Thesis (M.A.B.S.)--Multnomah Graduate School of Ministry, 1987. / Includes bibliographical references (leaves 66-70).

I argue for two main theses that are at odds with the positions of many clinical researchers and philosophers who write on the ethics of clinical research. The first is that certain types of clinical trials, namely, randomized clinical trials with double or triple blinding and a placebo group are generally necessary to establish that a medical intervention is effective in treating a certain type of disease or disorder. The second main thesis is that such trials are generally not ethically impermissible. My minimalist defense of clinical trials differs from most defenses of clinical trials found in the literature. I feel that the ethical permissibility of clinical trials can be judged by answering yes to the following questions: 1) Is the potential experimental subject competent to exercise his autonomy and his right of self determination in order to enroll in the clinical trial? 2) Is the potential experimental subject informed about the nature of risk and benefit involved in his participation in the clinical trial? 3) Is the trial scientifically/ epistemically valid? 4) Will the trial attempt to answer a scientific question or questions of value? I argue that competent persons have the right to enroll in scientifically valid clinical trials so long as they are informed and consent to participate.

As technology advances, health care decisions have become increasingly complex. American hospitals, based on accreditation standards, are required to have a system and process to address ethics, patient rights, and responsibilities. These practices vary widely, and there is very little consistency and few standards across the country. Key court cases have provided minor structure, and the federal government has been silent in the formulation of these structures but not necessarily in this arena. Most often, these accreditation standards related to clinical ethics are managed by Healthcare Ethics Committees (HEC). Bioethics has become a growing field, the level of integration between this discipline and healthcare practice varies widely. Using qualitative methods based on Grounded Theory, this analysis presents six key thematic findings, as well as interpretations to identify current challenges and opportunities to make recommendations for improvement by enhancing clarity and reducing ambiguity.

Wittgenstein once remarked that the same kind of reasoning that occurs in ordinary conversations about works of art can be found “in Ethics, but also in Philosophy.” That observation has been almost entirely overlooked by his commentators. What is aesthetic reasoning? What does it look like in conversations about art? And where might we find examples of such reasoning “in Ethics”? To set the stage for my answers, I begin with an overview of the early Wittgenstein’s view of ethics and aesthetics, emphasizing two ideas that were retained in his later view of aesthetic reasoning: the moral importance of non-moral descriptions, and the power of a “picture” to regulate action and thought. I illustrate those ideas by considering the moral influence of Tolstoy’s parable of the Good Samaritan on Wittgenstein. Next, I examine the passage in which Wittgenstein introduced aesthetic reasoning, and I articulate some general features of that concept. I also contend that we learn more about aesthetic reasoning by understanding Wittgenstein’s invention of the language-game concept as his reasoning aesthetically “in Philosophy.” Furthermore, I argue that the later Wittgenstein’s notions of aspect perception and grammatical pictures further inform aesthetic reasoning, revealing that it involves the introduction of grammar that can draw a person’s attention to unnoticed aspects of an object and equip him with further descriptions of that object. To illustrate that characterization of aesthetic reasoning, and to offer an example of such reasoning “in Ethics,” I return to Tolstoy’s parable and show that my interacting with it in a particular way involves aesthetic reasoning. Finally, I argue that aesthetic reasoning continues to occur in ethics in that it is woven into discussions of stories in bioethics classes. A student can have her grammatical picture of the case that a story presents reshaped as she sees and accepts aspects of that story that she had not noticed, and this, in turn, might influence her ways of seeing and responding morally to other cases. I close by considering whether aesthetic reasoning occurs in ethics in other ways, and I articulate some implications of my work for further Wittgenstein studies.

The study analyzes the ethical implications of human gene transfer technology for enhancement. Although human gene transfer technology is widely accepted on therapeutic grounds the non-therapeutic use of gene transfer technology remains to be a gray zone for moral deliberation. The present discussion addresses several ethical issues concerning the impacts of human gene transfer technology on individuals, the society, and future people. Accordingly, the study examines major ethical issues concerning the use of human gene transfer technology in general and genetic enhancement in particular, and reliability of the putative demarcation between therapy and enhancement, and further proposes ethical guidelines for non-therapeutic application of human gene transfer technology. A special attention is given to three major ethical issues, such as our obligation to future generations, problems concerning justice, fairness, and equality, and the problem of uncertainty.

A qualitative research study was conducted with people who had participated as healthy subjects in phase I drug trials at commercial research facilities, in order to develop a better understanding of their perspective regarding research participation. The participants were recruited using online advertisements posted on the University of Toronto student website (www.my.utoronto.ca) and NOW Magazine online. Thirty-one subjects were interviewed. The audiotaped interviews were transcribed and analyzed using grounded theory methods. A grounded theory was developed that describes the process of participation and the main factors affecting the experience of participation, from the perspective of healthy subjects. The theory, called Making Participation Work, explains how healthy subjects frame participation as an income earning opportunity, and how this framing shapes their behaviour with regard to participation. Participants expressed a range of attitudes about the experience of participation, from very positive to very negative. The main factor affecting the experience is the perceived net burden, which is in turn affected by the degree to which subjects find personal control over their participation. Net burden and finding personal control were both affected by the degree to which subjects felt valued by research staff, and by whether subjects had trust in the research enterprise. Although subjects framed participation as work, the relationship with the study doctors and nurses was viewed as clinical. Most subjects are generally trusting that participation in phase I drug trials is safe. These findings suggest that models of research participation assuming participation motivated by altruism or potential therapeutic benefit cannot accommodate the attitudes and behaviours of healthy subjects in phase I drug trials. New models must be developed which account for the framing of participation as work, while being sensitive to the trust that healthy subjects place in the research enterprise.

A qualitative research study was conducted with people who had participated as healthy subjects in phase I drug trials at commercial research facilities, in order to develop a better understanding of their perspective regarding research participation. The participants were recruited using online advertisements posted on the University of Toronto student website (www.my.utoronto.ca) and NOW Magazine online. Thirty-one subjects were interviewed. The audiotaped interviews were transcribed and analyzed using grounded theory methods. A grounded theory was developed that describes the process of participation and the main factors affecting the experience of participation, from the perspective of healthy subjects. The theory, called Making Participation Work, explains how healthy subjects frame participation as an income earning opportunity, and how this framing shapes their behaviour with regard to participation. Participants expressed a range of attitudes about the experience of participation, from very positive to very negative. The main factor affecting the experience is the perceived net burden, which is in turn affected by the degree to which subjects find personal control over their participation. Net burden and finding personal control were both affected by the degree to which subjects felt valued by research staff, and by whether subjects had trust in the research enterprise. Although subjects framed participation as work, the relationship with the study doctors and nurses was viewed as clinical. Most subjects are generally trusting that participation in phase I drug trials is safe. These findings suggest that models of research participation assuming participation motivated by altruism or potential therapeutic benefit cannot accommodate the attitudes and behaviours of healthy subjects in phase I drug trials. New models must be developed which account for the framing of participation as work, while being sensitive to the trust that healthy subjects place in the research enterprise.

<p>The study analyzes the ethical implications of human gene transfer technology for enhancement. Although human gene transfer technology is widely accepted on therapeutic grounds the non-therapeutic use of gene transfer technology remains to be a gray zone for moral deliberation. The present discussion addresses several ethical issues concerning the impacts of human gene transfer technology on individuals, the society, and future people. Accordingly, the study examines major ethical issues concerning the use of human gene transfer technology in general and genetic enhancement in particular, and reliability of the putative demarcation between therapy and enhancement, and further proposes ethical guidelines for non-therapeutic application of human gene transfer technology. A special attention is given to three major ethical issues, such as our obligation to future generations, problems concerning justice, fairness, and equality, and the problem of uncertainty.</p>

Thesis(Ph.D.)--Case Western Reserve University, 2010 / Title from PDF (viewed on 2010-01-28) Department of Bioethics Includes abstract Includes bibliographical references and appendices Available online via the OhioLINK ETD Center

Thesis (M.C.S.)--Regent College, 1999. / Includes abstract and vita. Includes bibliographical references (leaves 180-186).