The need for systematic reviews of reasons

There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews.     

African Bioethics vs. Healthcare Ethics in Africa: A Critique of Godfrey Tangwa

It is nearly two decades now since the publication of Godfrey Tangwa's article, ‘Bioethics: African Perspective’, without a critical review. His article is important because sequel to its publication in Bioethics, the idea of ‘African bioethics’ started gaining some attention in the international bioethics literature. This paper breaks this relative silence by critically examining Tangwa's claim on the existence of African bioethics. Employing conceptual and critical methods, this paper argues that Tangwa's account of African bioethics has some conceptual, methodic and substantive difficulties, which altogether do not justify the idea of African bioethics, at least for now. Contra Tangwa, this article establishes that while African bioethics remains a future possibility, it is more cogent that current efforts in the name of ‘African bioethics’ be primarily re‐intensified towards ‘Healthcare ethics in Africa’.     

Falsifications and corroborations: Karl Popper's influence on systematics

Over the last three decades, the philosophy of Karl Raimund Popper has had a strong influence on the field of systematic biology. Unequivocally, no other philosopher's work has had such an influence during this formative period in systematics. Much, but not all, of the early discourse on Popper and systematics dealt with the philosophical basis of systematics as a science. More recently Popper's work has been discussed in the systematics literature in relation to specific methodologies such as parsimony and maximum likelihood. In this paper, we provide the reader with a concise summary of Popper's ideas relevant to systematics, review the systematic literature invoking or declining Popper's importance to the field, and make a recommendation for the future course of philosophical thinking in systematics. We try to make clear various authors' interpretations of Popper's work and how those interpretations have impacted systematic thought. Although the reader may come away from this review with a clearer idea of Popper's relevance or lack thereof, our primary hope is that the reader will be compelled to question him- or herself about the philosophical basis of the systematic work that he or she does, and to delve into the literature herein cited. We begin by presenting a synopsis of Popper's philosophical views to allow those views to be placed in the context of systematics.     

THE FUTURE OF BIOETHICS: THREE DOGMAS AND A CUP OF HEMLOCK

In this paper I argue that bioethics is in crisis and that it will not have a future unless it begins to embrace a more Socratic approach to its leading assumptions. The absence of a critical and sceptical spirit has resulted in little more than a dominant ideology. I focus on three key issues. First, that too often bioethics collapses into medical ethics. Second, that medical ethics itself is beset by a lack of self‐reflection that I characterize here as a commitment to three dogmas. Third, I offer a more positive perspective by suggesting how bioethics may benefit from looking towards public health ethics as a new source of inspiration and direction.     

Addiction,Voluntary Choice,and Informed Consent: A Reply to Uusitalo and Broers

In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not – in contrast with a common assumption in the bioethics literature – depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes even if they do possess a capacity for self‐control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position.     

Bioethics in China

Historically, the preconditions for the emergence of bioethics in China. were political reforms and their applications. The Hanzhong Euthanasia Case and the publication of Qiu Ren-zong's academic work Bioethics played a significant role in the development of bioethics in China. Other contributory factors include the establishment of the Chinese Society of Medical Ethics/Chinese Medical Association (C.M.A), the publication of the Journal of Chinese Medical Ethics, and the teaching and education of bioethics in China. Major achievements of bioethics in China include the establishment of ethics committee and ethics review system, active international communication and cooperation among the academic circles, and the successful management of the 8th World Congress of Bioethics in Beijing in 2006. Chinese bioethics focus on native Chinese realities and conditions, absorb the international research achievements in relevant fields, and combine international ideas with traditional Chinese doctrines. Admittedly, there are still some aspects to be improved, yet bioethics has attracted a lot of attention from the core leadership in China and has gained sound financial support, which augers well for its further development. This article also briefly introduces the development of bioethics in Hong Kong and Taiwan, China.     

The conservation and tourism development of World Natural Heritage sites: The current situation and future prospects of research

The conservation and tourism development of World Heritage (WH) sites has always been a key and urgent scientific issue to be solved urgently by academia and industry all over the world. An increasing number of researchers and practitioners are paying attention to this issue. However, there is a lack of a comprehensive literature review on this topic. To fill this gap, this study conducts a systematic literature review (SLR) based on 179 related studies retrieved from the Web of Science (WoS) and Google Scholar (GS) databases. Focusing on the research question of the conservation and tourism development of World Natural Heritage (WNH) sites, we built an SLR framework to implement the review process. First, quantitative research was conducted to analyse the annual numbers, content and continents of the published literature. Second, we classified and summarized the main progress and achievements from theoretical research, technical methods, model construction, monitoring and evaluating, and application demonstration. Finally, in view of the current research situation of the conservation and tourism development of WNH sites, we proposed eight key scientific issues to be solved and several directions for future research.     

A search filter for increasing the retrieval of animal studies in Embase

Collecting and analysing all available literature before starting a new animal experiment is important and it is indispensable when writing systematic reviews of animal research. In practice, finding all animal studies relevant to a specific research question turns out to be anything but simple. In order to facilitate this search process, we previously developed a search filter for retrieving animal studies in the most often used biomedical database, PubMed. It is a general requirement for systematic reviews, however, that at least two databases are searched. In this report, we therefore present a similar search filter for a second important database, namely Embase. We show that our filter retrieves more animal studies than (a combination of) the options currently available in Embase. Our search filters for PubMed and Embase therefore represent valuable tools for improving the quality of (systematic) reviews and thereby of new animal experiments.     

From applied ethics to empirical ethics to contextual ethics

Bioethics became applied ethics when it was assimilated to moral philosophy. Because deduction is the rationality of moral philosophy, subsuming facts under moral principles to deduce conclusions about what ought to be done became the prescribed reasoning of bioethics, and bioethics became a theory comprised of moral principles. Bioethicists now realize that applied ethics is too abstract and spare to apprehend the specificity, particularity, complexity and contingency of real moral issues. Empirical ethics and contextual ethics are needed to incorporate these features into morality, not just bioethics. The relevant facts and features of problems have to be identified, investigated and framed coherently, and potential resolutions have to be constructed and assessed. Moreover, these tasks are pursued and melded within manifold contexts, for example, families, work and health care systems, as well as societal, economic, legal and political backgrounds and encompassing worldviews. This naturalist orientation and both empirical ethics and contextual ethics require judgment, but how can judgment be rational? Rationality, fortunately, is more expansive than deductive reasoning. Judgment is rational when it emanates from a rational process of deliberation, and a process of deliberation is rational when it uses the resources of non‐formal reason: observation, creative construction, formal and informal reasoning methods and systematic critical assessment. Empirical ethics and contextual ethics recognize that finite, fallible human beings live in complex, dynamic, contingent worlds, and they foster creative, critical deliberation and employ non‐formal reason to make rational moral judgments.     

Beyond the Sterility of a Distinct African Bioethics: Addressing the Conceptual Bioethics Lag in Africa

In the current debate on the future of bioethics in Africa, several authors have argued for a distinct communitarian African bioethics that can counter the dominancy of Western atomistic principlism in contemporary bioethics. In this article I examine this rather contentious argument and evaluate its validity and viability. Firstly, I trace the contextual origins of contemporary bioethics and highlight the rise and dominance of principlism. I particularly note that principlism was premised on a content‐thin notion of the common morality that is in need of enrichment. I also contend that bioethics is essentially two‐dimensional, being both conceptual and empirical, and indicate the lag in Africa with regard to conceptual bioethics. I then appeal for authentic engagement by 1) African health care professionals, 2) African health care training institutions, 3) Africa's bioethics development partners, and 4) African bioethicists and philosophers, towards addressing this critical lag. I underline the need to maintain the essential universality of bioethics as a discipline. I particularly argue against the pursuit of a distinct African bioethics, as it appears to be rooted in sterile African ethno‐philosophy. Rather, African bioethicists and philosophers would do well to elucidate the universalisability of insights from traditional African thought, for the benefit of bioethics as a whole. Thus we must engage beyond the sterility of a distinct African bioethics ‐ authentically reflecting on the essentially universal contemporary bioethical concerns ‐ to effectively articulate a viable trajectory for bioethics in Africa.     

Putting in shape – towards a unified approach for the taxonomic description of monogenean haptoral hard parts

Among monogeneans, haptoral hard parts provide prominent morphological characters upon which identifications are largely based. Traditionally, morphometric approaches are based on the use of arbitrary collections of linear distance measurements between landmarks. An exhaustive review of the specific diagnoses published in the journal Systematic Parasitology highlights the fact that an intricately important number of measurements are used to describe the same morphological features. Hence, this does not allow relevant comparison between studies and may have caused confusion in the literature. More importantly, a significant proportion of diagnoses commonly used do not maximize the amount of information available from morphological features, and sets of linear measurements between landmarks do not properly allow the complete reconstruction of the shape of haptoral hard parts. Given this prominent bias and the disparate use of traditional methodologies, I suggest the use of alternative methods in systematic parasitology that fully take into consideration the shape of morphological features. In addition to these considerations, a move toward placing shape at the centre of automated species recognition would be mutually beneficial for both taxonomists and non-taxonomists.     

Brain iron transport

Brain iron is a crucial participant and regulator of normal physiological activity. However, excess iron is involved in the formation of free radicals, and has been associated with oxidative damage to neuronal and other brain cells. Abnormally high brain iron levels have been observed in various neurodegenerative diseases, including neurodegeneration with brain iron accumulation, Alzheimer's disease, Parkinson's disease and Huntington's disease. However, the key question of why iron levels increase in the relevant regions of the brain remains to be answered. A full understanding of the homeostatic mechanisms involved in brain iron transport and metabolism is therefore critical not only for elucidating the pathophysiological mechanisms responsible for excess iron accumulation in the brain but also for developing pharmacological interventions to disrupt the chain of pathological events occurring in these neurodegenerative diseases. Numerous studies have been conducted, but to date no effort to synthesize these studies and ideas into a systematic and coherent summary has been made, especially concerning iron transport across the luminal (apical) membrane of the capillary endothelium and the membranes of different brain cell types. Herein, we review key findings on brain iron transport, highlighting the mechanisms involved in iron transport across the luminal (apical) as well as the abluminal (basal) membrane of the blood–brain barrier, the blood–cerebrospinal fluid barrier, and iron uptake and release in neurons, oligodendrocytes, astrocytes and microglia within the brain. We offer suggestions for addressing the many important gaps in our understanding of this important topic, and provide new insights into the potential causes of abnormally increased iron levels in regions of the brain in neurodegenerative disorders.     

Research ethics capacity development in Africa: exploring a model for individual success

The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has offered a fully-funded, one-year, non-degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub-Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees. Our data show that since 2001, the 28 former FABTP trainees have authored or co-authored 105 new bioethics-related publications; were awarded 33 bioethics-related grants; played key roles on 78 bioethics-related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post-training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs.     

Notes from a snail island: Littorinid evolution and adaptation

The most successful study systems are built on a foundation of decades of research on the basic biology, ecology and life history of the organisms in question. Combined with new technologies, this can provide a formidable means to address important issues in evolutionary biology and molecular ecology. Littorinid marine snails are a good example of this, with a rich literature on their taxonomy, speciation, thermal tolerance and behavioural adaptations. In August 2017, an international meeting on Littorinid evolution was held at the Tjärnö Marine Research Laboratory in Western Sweden. In this meeting review, I provide a summary of some of the exciting work on parallel evolution, sexual selection and adaptation to environmental stress presented there. I argue that newly available genomic resources present an opportunity for integrating the traditionally divergent fields of speciation and environmental adaptation in Littorinid research.     

Is an account of identity necessary for bioethics? What post-genomic biomedicine can teach us

Is a theory of identity necessary for bioethics? In this paper I investigate that question starting from an empirical explication of identity based on post-genomics, in particular on epigenetics. After analysing whether the classic problems a theory of identity has to cope with (fictional transplants; conjoined twins; and definition of death) also affect the proposed epigenetic account of identity, I deal with three topics (the assumption of moral responsibility; decision maintenance in the case of advance directives; and the attribution of value to human beings at given developmental stages) to offer an insight on the relationship between that account and bioethics.     

脊柱融合的实验研究进展

脊柱融合是脊柱外科研究重点之一,脊柱融合的动物实验研究也是方兴未艾,有关脊柱融合的实验动物选择、实验方法、实验材料、评价方法是研究的重点。本文通过大量文献进行系统回顾,对脊柱融合动物实验的上述方面进行了总结。     

Teaching global bioethics

We live in a world with enormous disparities in health. The life expectancy in Japan is 80 years; in Malawi, 40 years. The under-five mortality in Norway is 4/1000; in Sierra Leone, 316/1000. The situation is actually worse than these figures suggest because average rates tend to mask inequalities within a country. Several presidents of the IAB have urged bioethicists to attend to global disparities and to broaden the scope of bioethics. For the last six years I have tried to do just that. In this paper, I report and reflect on my attempts to teach bioethics in ways that address global health and justice. I then discuss ways to address key ethical issues in global health: the problem of inequalities; the nature of the duty to assist; the importance of the duty not to harm; the difference between a cosmopolitan and a political view of justice. I also discuss how teaching about global health may help to shift the emphasis in bioethics--from sensational cases to everyday matters, from autonomy and justice, and from access to healthcare to the social determinants of health. At the end of my paper, I reflect on questions that I have not resolved: how to delineate the scope of bioethics, whether my approach over-politicises bioethics, and how to understand the responsibilities of bioethicists.     

Uncertainty in life cycle costing for long-range infrastructure. Part II: guidance and suitability of applied methods to address uncertainty

Life cycle costing (LCC) is the state-of-the-art method to economically evaluate long-term projects over their life spans. However, uncertainty in long-range planning raises concerns about LCC results. In Part I of this series, we developed a holistic framework of the different types of uncertainty in infrastructure LCCs. We also collected methods to address these uncertainties. The aim of Part II is to evaluate the suitability of methods to cope with uncertainty in LCC. Part I addressed two research gaps. It presented a systematic collection of uncertainties and methods in LCC and, furthermore, provided a holistic categorization of both. However, Part I also raised new issues. First, a combined analysis of sources and methods is still outstanding. Such an investigation would reveal the suitability of different methods to address a certain type of uncertainty. Second, what has not been assessed so far is what types of uncertainty are insufficiently addressed in LCC. This would be a feature to improve accuracy of LCC results within LCC, by suggesting options to better cope with uncertainty. To address these research gaps, we conducted a systematic literature review. Part II analyzed the suitability of methods to address uncertainties. The suitability depends on data availability, type of data (tangible, intangible, random, non-random), screened hotspots, and tested modeling specifications. We identified types of uncertainties and methods that have been insufficiently addressed. The methods include probabilistic modeling such as design of experiment or subset simulation and evolutionary algorithm and Bayesian modeling such as the Bayesian latent Markov decision process. Subsequently, we evaluated learning potential from other life cycle assessment (LCA) and life cycle sustainability assessment (LCSA). This analysis revealed 28 possible applications that have not yet been used in LCC. Lastly, we developed best practices for LCC practitioners. This systematic review complements prior research on uncertainty in LCC for infrastructure, as laid out in Part I. Part II concludes that all relevant methods to address uncertainty are currently applied in LCC. Yet, the level of application is different. Moreover, not all methods are equally suited to address different categories of uncertainty. This review offers guidance on what to do for each source and type of uncertainty. It illustrates how methods can address both based on current practice in LCC, LCA, and LCSA. The findings of Part II encourage a dialog between practitioners of LCC, LCA, and LCSA to advance research and practice in uncertainty analysis.     

国内工业生态安全研究述评

经过对国内工业生态安全研究文献的梳理与评价,从一个侧面比较系统地反映了国内该领域研究的现状、重点内容及发展趋势,指出了研究的若干重要进展及存在的不足。在此基础上,对今后我国工业生态安全研究提出了展望与建议。调研发现,国内学者在基础研究、应用研究方面都取得了明显进展:借鉴、界定和运用了一些重要概念;开拓了工业生态安全应用研究的两个重点领域。但是其不足也比较明显:基础理论研究非常薄弱;应用研究的尺度主要是中观层次(区域、行业、工业园区等),企业及国家层面工业生态安全等微观和宏观层次的专题系统研究文献比较少;研究方法上综合交叉研究、实证研究、定量分析比较薄弱。因此,应该大力加强工业生态安全基础性理论问题研究,重视实证研究与定量分析,紧紧抓住工业生态安全研究综合性与交叉性强的特点,在重点研究高耗能行业及工业自然生态环境安全的同时,注意拓展对工业经济生态环境安全、社会生态环境安全以及工业自然-经济-社会复合生态系统综合生态安全的研究。为此,应该建立各相关学科与部门有效沟通、官产学研合作攻关的协调机制。