Cynthia Townley

Technology and Academic Virtue: Student Plagiarism Through the Looking Glass

Plagiarism is the misuse of and failure to acknowledge source materials. This paper questions common responses to the apparent increase in plagiarism by students. Internet plagiarism occurs in a context – using the Internet as an information tool – where the relevant norms are far from obvious and models of virtue are difficult to identify and perhaps impossible to find. Ethical responses to the pervasiveness of Internet-enhanced plagiarism require a reorientation of perspective on both plagiarism and the Internet as a knowledge tool. Technological strategies to “catch the cheats” send a “don’t get caught” message to students and direct the limited resources of academic institutions to a battle that cannot be won. More importantly, it is not the right battleground. Rather than characterising Internet-enabled plagiarism as a problem generated and solvable by emerging technologies, we argue that there is a more urgent need to build the background conditions that enable and sustain ethical relationships and academic virtues: to nurture an intellectual community.

Ethical challenges of innovative surgery: a response to the IDEAL recommendations

1–3 addresses some but not all these concerns. Here, we build on this important work by identifying gaps that warrant further attention and by making additional suggestions for dealing with the ethical challenges associated with surgical innovation. The most obvious source of patient harm is physical, with the potential for increased mortality and morbidity from innovations compared with standard treatment. This concern is supported by historical reports in which innovative surgery has generated harm—eg, by routine episiotomy, treatment of peptic ulcer disease with gastric freezing, and early eff orts to artifi cially sustain circulation with implant devices. 4 Although technologies might be independently safe and eff ective, their combination could generate unanticipated problems—eg, a major innovation in gastrointestinal surgery, laparoscopic cholecystectomy, resulted in a substantial increase in biliary injuries. 5 Noneff ective treatments also generate potential harms, since surgery itself is not benign; ancillary risks arise from infection and anaesthesia, and the commitment to surgical intervention could mean other treatment options are foreclosed. Even if new procedures are deemed safe and eff ective, the learning curves associated with innovative treatments heighten risks to patients while a surgeon obtains competency in such procedures. Additionally, there can be burdens for patients and their families that are caused by innovative surgery, which go beyond physical diffi culties, and include fi nancial and psychological hardship. 4

Equity Under the Knife: Justice and Evidence in Surgery

Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations.

More on Enrolling Female Students in Science and Engineering

This paper investigates reasons for practices and policies that are designed to promote higher levels of enrolment by women in scientific disciplines. It challenges the assumptions and problematic arguments of a recent article questioning their legitimacy. Considering the motivations for and merits of such programs suggests a practical response to the question of whether there should be programs to attract female science and engineering students.

Virtual Communities, Ethics of

The emergence of virtual communities raises ethical issues in new forms. A virtual community is a social group in which members interact using information and communication technologies. Virtual communities elicit a similar range of good and bad behavior, inclusions and exclusions, benefits and costs as characterize offline communities. They can also alter ethical behavior, both for good and for ill.

Understanding corporate responsibility: Culture and complicity

Kipniss fictional account of the televised treatment of Elaine Robbins clearly shows the surgeons negligence (Kipnis 2011). The problems with Anodynes support for the telesurgery breakfast are harder to discern, but show up clearly when we take into consideration how surgical evidence is generated, evaluated, and used by surgeons. Current evidentiary practices in surgery have two major weaknesses, related to the epistemic culture of surgery and to practices of knowledge transmission. We argue that this is a systemic problem, which companies such as Anodyne both contribute to and benefit from. Thus, while we agree with Kipniss claim that Anodyne is complicit in creating “conditions of danger,” we believe that Anodynes contributory roles extend beyond creating moral hazards for susceptible surgeons and harms for individual patients. The Epistemic Culture of Surgery By the epistemic culture of surgery, we mean the traditions and practices surrounding the generation, transmission, and uptake of new knowledge in surgery. The traditional research-totreatment pathway starts with a series of clinical trials to test the safety and efficacy of a new drug or device. Such research results are communicated to practitioners via publications in reputable peer-reviewed journals, and used by regulatory bodies such as the U.S. Food and Drug Administration in decisions about whether to approve use of the novel treatment. For several reasons this ideal pathway does not function well in surgery. First, surgery lacks a strong foundation in the kind of evidence that characterizes evidence-based medicine (EBM). The best evidence requires results generated by rigorous research such as randomized controlled trials (RCTs), or syntheses of such trials in systematic reviews. Mounting RCTs in surgery is more difficult than RCTs involving drugs. Not only do surgeons provide interventions that are inherently more open to variation than a relatively straightforward prescribing regime, but outcomes may be affected by a range of factors including operating theatres, team composition, postoperative care, and so forth. There are further reasons for surgerys weak evidence base arising from methodological and ethical issues unique to surgical research: difficulties with control groups or blinding; justifying the harms intrinsic to sham surgery in surgical RCTs; and problems of equipoise. Equipoise requires that the investigator be genuinely uncertain as to the merits of two candidate treatments, but is difficult to achieve because the typical orientation of surgeons “characterized by confidence and decisiveness” fits poorly with admitting uncertainty about treatment options (Miller and Brody 2003, 554). The literature reflects these difficulties: Only 3.4%