Should We Reject Donated Organs on Moral Grounds or Permit Allocation Using Non‐Medical Criteria?: A Qualitative Study

Conditional and directed deceased organ donations occur when donors (or often their next of kin) attempt to influence the allocation of their donated organs. This can include asking that the organs are given to or withheld from certain types of people, or that they are given to specified individuals. Donations of these types have raised ethical concerns, and have been prohibited in many countries, including the UK. In this article we report the findings from a qualitative study involving interviews with potential donors (n = 20), potential recipients (n = 9) and transplant staff (n = 11), and use these results as a springboard for further ethical commentary. We argue that although participants favoured unconditional donation, this preference was grounded in a false distinction between ‘medical’ and ‘non‐medical’ allocation criteria. Although there are good reasons to maintain organ allocation based primarily upon the existing ‘medical’ criteria, it may be premature to reject all other potential criteria as being unacceptable. Part of participants' justification for allocating organs using ‘medical’ criteria was to make the best use of available organs and avoid wasting their potential benefit, but this can also justify accepting conditional donations in some circumstances. We draw a distinction between two types of waste – absolute and relative – and argue that accepting conditional donations may offer a balance between these forms of waste.     

Zika,contraception and the non‐identity problem

The 2016 outbreak of the Zika arbovirus was associated with large numbers of cases of the newly‐recognised Congenital Zika Syndrome (CZS). This novel teratogenic epidemic raises significant ethical and practical issues. Many of these arise from strategies used to avoid cases of CZS, with contraception in particular being one proposed strategy that is atypical in epidemic control. Using contraception to reduce the burden of CZS has an ethical complication: interventions that impact the timing of conception alter which people will exist in the future. This so‐called ‘non‐identity problem’ potentially has significant social justice implications for evaluating contraception, that may affect our prioritisation of interventions to tackle Zika. This paper combines ethical analysis of the non‐identity problem with empirical data from a novel survey about the general public's moral intuitions. The ethical analysis examines different perspectives on the non‐identity problem, and their implications for using contraception in response to Zika. The empirical section reports the results of an online survey of 93 members of the US general public exploring their intuitions about the non‐identity problem in the context of the Zika epidemic. Respondents indicated a general preference for a person‐affecting intervention (mosquito control) over an impersonal intervention (contraception). However, their responses did not appear to be strongly influenced by the non‐identity problem. Despite its potential philosophical significance, we conclude from both theoretical considerations and analysis of the attitudes of the community that the non‐identity problem should not affect how we prioritise contraception relative to other interventions to avoid CZS.     

Acceptance and Perception of Nigerian Patients to Medical Photography

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self‐administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non‐identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non‐identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital‐owned camera to personal camera/personal camera‐phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non‐identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera‐phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice.     

Canine Reconciliation and Third‐Party‐Initiated Postconflict Affiliation: Do Peacemaking Social Mechanisms in Dogs Rival Those of Higher Primates?

Conflicts over food, access to mates, or other limited resources can sometimes escalate into aggression. In species that form social groups, these aggressive conflicts can jeopardize the benefits of group living, such as enhanced access to valued resources, necessitating the development of behavioural mechanisms that either mitigate conflicts, prevent aggressive escalation or resolve disputes. Two important mechanisms for managing the effects of disputes involve postconflict (PC) affiliative behaviour, either between the former opponents (called ‘reconciliation’) or between one opponent and a third party. Even though numerous studies have tested reconciliatory and third‐party affiliation tendencies in primates, for non‐primate animals little systematic data are available. We performed behavioural observations on three groups of captive domestic dogs (Canis familiaris) and used a PC/MC method to test the existence of reconciliation and third‐party affiliation in this species. The results of this study clearly indicate that both reconciliation and third‐party PC interactions are present in the domestic dog, and form important social mechanisms of the domestic dog. Furthermore, familiar individuals showed a significantly higher proportion of reconciled conflicts than did unfamiliar individuals, and also displayed fewer conflicts. Finally, we show that most of the third‐party affiliations involve the victim of a conflict and that victim‐directed affiliation outweighs victim‐initiated third‐party affiliation in these PC interactions.     

Opt‐in or opt‐out to increase organ donation in South Africa? Appraising proposed strategies using an empirical ethics analysis

Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa (SA). We conclude that SA should maintain its soft opt‐in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt‐in system, SA faces the challenge of how to increase donor numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy. We argue that a hard opt‐in, opt‐out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt‐in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level. However, to circumvent some of the clinical‐level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt‐in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries.     

Internet racism,journalism and the principle of public access: ethical challenges for qualitative research into ‘media attractive’ court cases

This paper addresses the risk of research exposing people with an immigrant background in criminal court cases to Internet-based racist persecution, due to mismanagement of general ethical guidelines. The principle of informed consent, ideally serving to protect people under study from harm may, in fact, cause them more harm due to the interest among certain Internet-based networks of spreading identifiable, degrading information. Arguments are based on ethically challenging experiences from two ethnographic research projects carried out in Swedish district court environments, focused on immigrant court cases. Ethical advice provided by ethical review boards and established research guidelines, were based on an unawareness of the potentially destructive rendezvous in media attractive immigrant court cases between ‘ethically informed’ research, crime journalism, freedom of information legislation and ‘Internet vigilantes’ on a quest to persecute court participants and their families in the global digital arena.     

Reconciliation and the Costs of Aggression in Wild Barbary Macaques (Macaca sylvanus): A Test of the Integrated Hypothesis

The ‘integrated hypothesis’ predicts that reconciliation (the post‐conflict friendly interaction between former opponents observed in various group‐living species) functions to reduce anxiety and the risk of aggression from the former opponent or a bystander in the aftermath of a conflict. It also predicts that relationship quality between opponents affects the occurrence of reconciliation and modulates the anxious response of the opponents after a conflict. Because of the asymmetric nature of aggressive interactions, the cost of aggression is likely to differ between the victim and the aggressor. The aim of this study was to test the predictions of the ‘integrated hypothesis’ independently for the victim and the aggressor of a conflict. We collected data on two wild groups of Barbary macaques. This study represents, to our knowledge, the first systematic test of the integrated hypothesis on wild, non‐provisioned animals. Victims of aggression were at a greater risk of receiving aggression from the former opponent or a bystander after a conflict and showed elevated anxiety. We found no such costs for the aggressor. Reconciliation reduced anxiety in the victim but did not reduce their risk of receiving aggression. Finally, relationship quality affected the occurrence of reconciliation but did not modulate post‐conflict anxiety. The results of our study show that the costs of aggression are asymmetrically distributed between the victim and the aggressor. Such differences are likely to lead to different social tactics used by the victim and the aggressor in the aftermath of a conflict.     

Novel bioactive natural products from bacteria via bioprospecting,genome mining and metabolic engineering

For over seven decades, bacteria served as a valuable source of bioactive natural products some of which were eventually developed into drugs to treat infections, cancer and immune system-related diseases. Traditionally, novel compounds produced by bacteria were discovered via conventional bioprospecting based on isolation of potential producers and screening their extracts in a variety of bioassays. Over time, most of the natural products identifiable by this approach were discovered, and the pipeline for new drugs based on bacterially produced metabolites started to run dry. This mini-review highlights recent developments in bacterial bioprospecting for novel compounds that are based on several out-of-the-box approaches, including the following: (i) targeting bacterial species previously unknown to produce any bioactive natural products, (ii) exploring non-traditional environmental niches and methods for isolation of bacteria and (iii) various types of ‘genome mining’ aimed at unravelling genetic potential of bacteria to produce secondary metabolites. All these approaches have already yielded a number of novel bioactive compounds and, if used wisely, will soon revitalize drug discovery pipeline based on bacterial natural products.     

Emancipating ethics: an autonomist reading of Islamic forms of life in Russia

This article advances a framework aimed at capturing the political life of ethical intensity by putting autonomist theory in resonance with ethnographic material pertaining to quietist Muslim milieus in post-Soviet Russia. The emancipatory and prefigurative potential of collective projects of self-legislation – in this case, ‘halal living’ – are explored through the notions of ethical form of life and Rule/Law. It will be argued that autonomist theory (a) is helpful in conceptualizing the friction between ethical projects (however quietist) and dominant moral/political orders; (b) has the potential to broaden anthropological conversations on virtue beyond existing fault lines (notably between what I call ‘traditionist’ and ‘liberal’ theoretical families) as well as conceptual silos (‘religion', ‘secularity’); and (c) can help us envision a radical, politically engaged anthropology of ethics.     

Altruism and Reward: Motivational Compatibility in Deceased Organ Donation

Acts of helping others are often based on mixed motivations. Based on this claim, it has been argued that the use of a financial reward to incentivize organ donation is compatible with promoting altruism in organ donation. In its report Human Bodies: Donation for Medicine and Research, the Nuffield Council on Bioethics uses this argument to justify its suggestion to pilot a funeral payment scheme to incentivize people to register for deceased organ donation in the UK. In this article, I cast a sceptical eye on the above Nuffield report's argument that its proposed funeral payment scheme would prompt deceased organ donations that remain altruistic (as defined by and valued the report). Specifically, I illustrate how this scheme may prompt various forms of mixed motivations which would not satisfy the report's definition of altruism. Insofar as the scheme produces an expectation of the reward, it stands diametrical to promoting an ‘altruistic perspective’. My minimal goal in this article is to argue that altruism is not motivationally compatible with reward as an incentive for donation. My broader goal is to argue that if a financial reward is used to incentivize organ donation, then we should recognize that the donation system is no longer aiming to promote altruism. Rewarded donation would not be altruistic but it may be ethical given a persistent organ shortage situation.     

Primum Non Nocere: Obesity Stigma and Public Health

Several recent anti-obesity campaigns appear to embrace stigmatization of obese individuals as a public health strategy. These approaches seem to be based on the fundamental assumptions that (1) obesity is largely under an individual’s control and (2) stigmatizing obese individuals will motivate them to change their behavior and will also result in successful behavior change. The empirical evidence does not support these assumptions: Although body weight is, to some degree, under individuals’ personal control, there are a range of biopsychosocial barriers that make weight regulation difficult. Furthermore, there is accumulating evidence that stigmatizing obese individuals decreases their motivation to diet, exercise, and lose weight. Public health campaigns should focus on facilitating behavioral change, rather than stigmatizing obese people, and should be grounded in the available empirical evidence. Fundamentally, these campaigns should, first, do no harm.     

Drought limitations to leaf‐level gas exchange: results from a model linking stomatal optimization and cohesion–tension theory

We merge concepts from stomatal optimization theory and cohesion–tension theory to examine the dynamics of three mechanisms that are potentially limiting to leaf‐level gas exchange in trees during drought: (1) a ‘demand limitation’ driven by an assumption of optimal stomatal functioning; (2) ‘hydraulic limitation’ of water movement from the roots to the leaves; and (3) ‘non‐stomatal’ limitations imposed by declining leaf water status within the leaf. Model results suggest that species‐specific ‘economics’ of stomatal behaviour may play an important role in differentiating species along the continuum of isohydric to anisohydric behaviour; specifically, we show that non‐stomatal and demand limitations may reduce stomatal conductance and increase leaf water potential, promoting wide safety margins characteristic of isohydric species. We used model results to develop a diagnostic framework to identify the most likely limiting mechanism to stomatal functioning during drought and showed that many of those features were commonly observed in field observations of tree water use dynamics. Direct comparisons of modelled and measured stomatal conductance further indicated that non‐stomatal and demand limitations reproduced observed patterns of tree water use well for an isohydric species but that a hydraulic limitation likely applies in the case of an anisohydric species.     

‘Rules that apply in times of crisis’: time,agency, and norm‐remaking during Nepal's People's War

This article explores how people in the former Maoist heartland of Nepal adopted previously transgressive norms and practices during the decade of the People's War (1996‐2006). By examining the rise in practices of beef‐eating and inter‐caste commensality, this article suggests that the temporal dimension of wartime ‘when different rules apply’ was crucial in making people accept new ideas and break established norms on a scale atypical for the ‘normal’ times of peace. Analysing the agency of Maoist activists, who self‐consciously tried to implement a project of radical social transformation, and those people who were caught in the midst of the Maoist transformative endeavour, this article argues that the contours of the ‘new society’ emerged not only due to revolutionaries’ intentional actions but also because of the ‘exceptional’ nature of wartime, which forced people to radically re‐create their daily lives. By transgressing social norms, ‘ordinary’ people did not deliberately undermine the normative order, but rather responded to the constraints of wartime, when people's agency and ethical choices were mostly driven by the need to secure the survival of their families and ensure the continuity of life itself.     

Procreation,Personhood and ethnic difference in Highland Bolivia

Academic debates on the difference between ‘indians’ and ‘non‐indians’ in highland Latin America typically revolve around issues of race, ethnicity and class understood from an etic perspective. Although there may be a consensus as to where the boundary between one status and the other lies, how this boundary is understood varies dramatically between scholars, as well as between actors on each side of the boundary. This paper examines the identity of those denominated ‘indian’ from an emic perspective. It argues that ‘race’, ‘ethnicity'and ‘class’ are insufficient in themselves to explain this level of social difference. At the root of the difference between jaqi (indians) and q'ara (non‐indians) are understandings of personhood. An examination of procreation beliefs and understandings of personhood sheds light on how identity is understood. The dyads indian/non‐indian and jaqi/q'ara are not, of course, generated independently of each other and this paper also examines how the one articulates with the other. Although the category ‘indian’ is one imposed historically from outside, this does not preclude people's ability to generate a different understanding of that category from within.     

A prospectus for ethical analysis of ageing individuals' responsibility to prevent cognitive decline

As the world's population ages, governments and non‐governmental organizations in developed countries are promoting healthy cognitive ageing to reduce the rate of age‐related cognitive decline and sustain economic productivity in an ageing workforce. Recommendations from the Productivity Commission (Australia), Dementia Australia, Government Office for Science (UK), Presidential Commission for the Study of Bioethical Issues (USA), Institute of Medicine (USA), among others, are encouraging older adults to engage in mental, physical, and social activities. These lifestyle recommendations for healthy cognitive ageing are timely and well supported by scientific evidence but they make implicit normative judgments about the responsibility of ageing individuals to prevent cognitive decline. Ethical tensions arise when this individual responsibility collides with social and personal realities of ageing populations. First, we contextualize the priority given to healthy cognitive ageing within the current brain‐based medical and social discourses. Second, we explore the individual responsibility by examining the economic considerations, medical evidence and individual interests that relate to the priority given to healthy cognitive ageing. Third, we identify three key ethical challenges for policymakers seeking to implement lifestyle recommendations as an effective population‐level approach to healthy cognitive ageing. The result is a prospectus for future in‐depth analysis of ethical tensions that arise from current policy discussions of healthy cognitive ageing.     

THE RACE TOWARD ‘ETHICALLY UNIVERSALLY ACCEPTABLE’ HUMAN PLURIPOTENT (EMBRYONIC‐LIKE) STEM CELLS: ONLY A PROBLEM OF SOURCES?

Over the past few years, several proposals aimed at procuring human pluripotent (embryonic‐like) stem cells without involving the destruction of a human embryo have been proposed and widely discussed. This article focuses on a basic aspect of the debate, namely the plausibility of one or more of these new proposals being able to meet the ethical requirements that those who regard the human embryo as sacred have tried to impose on stem cells research in the last ten years. The thesis of the article is that focusing the discussion only on the sources of stem cells has prevented a full understanding of the foundation, meaning and scope of these ethical requirements. To substantiate this thesis, the article takes into consideration two issues: the first has to do with the potential of the cells obtained through some of the new approaches (iPS included), the second (and decisive) with the argument of the ‘indirect complicity’, applied to the use of ‘contaminated’ knowledge.     

The social organisation of Wadeye's heavy metal mobs

The heavy metal mobs of Wadeye (notorious in the media as ‘heavy metal gangs’) are a new form of Aboriginal social organisation, almost entirely constituted by collateral kinship rather than descent relations. Dozens of overlapping mobs are each made up of sets of brothers and cousins, and are publicly symbolised by the name of a heavy metal band discovered via mass media. In contrast to recent Australianist anthropology that emphasises the fluidity of social structures and intercultural processes of identity formation, I argue that the metal mobs constitute a highly codified system of social organisation, and one in which non‐Aboriginal cultural influences are quite peripheral.     

The Nation‐State,Public Education,and the Logic of Migration: Chinese Students in Hungary

Public education remains the nation‐state's foremost instrument of forging citizens. But the emergence of ‘international education’, a system explicitly based on the ideology of globality and outside the purview of national curricula, provides a way to circumvent the citizen‐making machine. This article, based on fieldwork among Chinese secondary school students in Hungary, considers the interaction between ‘international education’ and transnational migrants in a nation‐state whose public education, as the state itself, has little interest in the ‘integration’ of non‐natives.     

The influence of host and non‐host companion plants on the behaviour of pest insects in field crops

Companion plants grown as ‘trap crops’ or ‘intercrops’ can be used to reduce insect infestations in field crops. The ways in which such reductions are achieved are being described currently using either a chemical approach, based on the ‘push‐pull strategy’, or a biological approach, based on the ‘appropriate/inappropriate landing theory’. The chemical approach suggests that insect numbers are reduced by chemicals from the intercrop ‘repelling’ insects from the main crop, and by chemicals from the trap‐crop ‘attracting’ insects away from the main crop. This approach is based on the assumptions that (1) plants release detectable amounts of volatile chemicals, and (2) insects ‘respond’ while still some distance away from the emitting plant. We discuss whether the above assumptions can be justified using the ‘appropriate/inappropriate landing theory’. Our tenet is that specialist insects respond only to the volatile chemicals released by their host plants and that these are released in such small quantities that, even with a heightened response to such chemicals, specialist insects can only detect them when a few metres from the emitting plant. We can find no robust evidence in the literature that plant chemicals ‘attract’ insects from more than 5 m and believe that ‘trap crops’ function simply as ‘interception barriers’. We can also find no evidence that insects are ‘repelled’ from landing on non‐host plants. Instead, we believe that ‘intercrops’ disrupt host‐plant finding by providing insects with a choice of host (appropriate) and non‐host (inappropriate) plant leaves on which to land, as our research has shown that, for intercropping to be effective, insects must land on the non‐host plants. Work is needed to determine whether non‐host plants are repellent (chemical approach) or ‘non‐stimulating’ (biological approach) to insects.     

The annual Day of the Dead song contest: musical‐linguistic ideology and practice,piratability, and the challenge of scale

Building on research theorizing scale, this article proposes augmentations to existing frameworks that will help illuminate how localities are linked to ‘stranger collectives’ like nations, ethnicities, and global religious ‘communities’. In this case of ethnic revival from Mexico's Sierra Mazateca, people use new vernacular literacy practices tied to local musical performances as a way of ‘customizing’ modular forms deployed by national and global institutions to manage indigenous difference. People ‘re‐imagine’ locality through a localized indigenous literacy that takes templates provided by the Mexican state and the Catholic Church and places them in productive tension with local context: musical properties of the indigenous language Mazatec, locally valued performance practices, and local musical‐linguistic ideologies. While this revival movement draws on immanently modular forms, once locally embedded they become ‘unpiratable’, and constitute a new resource for inscribing local belonging. This case suggests the importance of considering linguistic and musical aspects of social context often taken for granted in anthropological investigations of scale.