El objetivo de este artículo es mostrar la necesidad de abordar de forma coherente los tres temas que se deben analizar en el campo de la justicia en salud. El primero remite al ámbito ético-jurídico de un supuesto derecho a la salud. El segundo es el tema de las desigualdades injustas en salud que se derivan de las desigualdades sociales y económicas. Y el tercero es el tema de la priorización o racionamiento sanitario en un contexto de recursos limitados. En (...) el artículo, describo las principales preguntas y problemas que se suscitan en dichos ámbitos y esbozo algunas conclusiones en cada uno de ellos. También advierto de la necesidad de construir una teoría de la justicia en salud que proporcione una respuesta coherente e integradora de los tres temas. (shrink)

La pobreza extrema y la enorme desigualdad global son un mal de nuestro tiempo, pero ¿son una injusticia? Se indican diferentes tipos de obligaciones morales globales y se critican los enfoques que 1) niegan las obligaciones de justicia en un contexto global, 2) priorizan sistemáticamente las obliga..

RESUMENEl mérito es un valor absolutamente presente en nuestra sociedad, hasta el punto de que a su alrededor gira un modelo social propio: la meritocracia. El mérito y la meritocracia suelen asociarse a las aspiraciones igualitaristas de quienes confían en que los individuos sean valorados, en el acceso a las posiciones sociales, por su capacidad y no por otros requisitos moralmente irrelevantes como el origen social, étnico, cultural, el sexo, el aspecto físico, las creencias religiosas o la ideología. Pero, paradójicamente, (...) tanto el mérito como la meritocracia tienen un escaso compromiso con el valor de la igualdad.PALABRAS CLAVEMÉRITO, MERITOCRACIA, IGUALDAD, IGUALDAD DE OPORTUNIDADES.ABSTRACTMerit is a moral value very present in our society. Around it, we have a specific social model: meritocracy. Usually, we think that to a large extent merit and meritocracy are part of an egalitarian society, in which everybody is treated, in the access to social positions, by their capabilities and not by arbitrary elements like social or cultural background, etnics, sex, physical appearance, religious believes or ideology. But, paradoxically, merit and meritocracy have a very little compromise with the value of equality.KEY WORDSMERIT, MERITOCRACY, EQUALITY, EQUALITY OF OPPORTUNITY. (shrink)

Rare diseases generally receive less funding for their medical research and treatments than other diseases. Apart from well-known scientific and economic explanations, there are two major ethical positions regarding this fact, the one that approves it for reasons of utilitarian ethics, and the one that condemns it by insisting on egalitarian and individual rights reasons. In this article, I analyse the problems of both types of moral justification, and propose an ethical alternative based on the idea of political fraternity that, (...) applied to rare diseases, avoids the worst consequences of both utilitarianism and the language of individual rights to health and mere egalitarianism. (shrink)

Uno de los logros indiscutibles de la obra de John Rawls ha sido la revitalización del concepto de igualdad en la ética y la filosofía política de los últimos años, desmonopolizándolo de las ideologías que han recorrido con mejor o peor fortuna todo el siglo xx y devolviéndolo al rigor analítico y conceptual de la filosofía. Además, con la virtud añadida de armonizar el valor de la igualdad con los valores de la libertad y la eficiencia: un esfuerzo no siempre (...) valorado con suficiente comprensión. No hay duda, pues, de la influencia de la teoría de la justicia de Rawls en el pensamiento igualitarista actual que, de algún modo, se ha construido -y aún continúa haciéndolo- siguiendo -o bien desmarcándose de- la estela trazada por el filósofo de Harvard. En este artículo, analizo los principales debates abiertos en tomo al igualitarismo rawlsiano y apunto alguna posible orientación futura. En primer lugar, expongo los dos grandes argumentos igualitaristas en la obra de Rawls, derivados, respectivamente, de la concepción moral de la persona y de la arbitrariedad moral de las contingencias sociales y naturales de los individuos. Posteriormente, exploro los problemas de ambos argumentos insistiendo, por un lado, en la inadecuación de la personalidad moral kantiana como fundamento de una teoría igualitarista y, por otro, en la incoherencia del igualitarismo de la suerte como extensión igualitarista de la teoría rawlsiana. En tercer lugar, muestro que el principal problema igualitarista en la obra de Rawls proviene de una concepción de la igualdad o equidad vacía de solidaridad. Concluyo, finalmente, que a la justicia como equidad habría que contraponerle una justicia como fraternidad. (shrink)

Presentación del monográfico sobre Fraternidad de Daimon-Revista Internacional de Filosofía).

La fraternidad es una idea política con una larga trayectoria histórica y forma parte del nacimiento de la política moderna durante el período de la Revolución francesa junto a las ideas de libertad e igualdad. No obstante, la fraternidad ha recibido muy poca atención por parte de la filosofía política contemporánea. En este artículo, realizo un análisis conceptual de la idea política de fraternidad con el fin de identificar los elementos comunes y distintivos de la misma.

Una de las cuestiones que debería preocupar más a la teoría de la justicia global es la enorme desigualdad de salud que hay en el mundo. En este artículo, se repasan las causas de la desigualdad global de salud y los argumentos éticos a favor y en contra de la necesidad de tratar dicha desigualdad desde la perspectiva de la justicia global. Tras rechazar los argumentos en contra tanto del libertarismo de derechas como del estatalismo, y tras exponer las críticas (...) tanto al lenguaje de los derechos humanos como a la propuesta poggeana de reducir los deberes de la justicia global a deberes morales negativos, defiendo la necesidad de partir de un criterio de justicia global suficientista y basado en los deberes morales positivos para afrontar la gravedad y la urgencia moral que suponen las desigualdades globales de salud. (shrink)

Extreme poverty and tremendous inequality are an evil of our times, but do they constitute injustice? The article discusses different types of global moral obligations and criticizes those that 1) reject obligations of justice in a global context, 2)systematically prioritize special obligations, and 3) reduce the main obligations ofglobal justice to negative duties. Without necessarily defending global egalitarianism, it is possible to justify the redistribution of wealth in the world on the basis of a wide interpretation of the duty to (...) help and the right to survival. (shrink)

This interdisciplinary volume gathers selected, refereed contributions on various aspects of public health from several disciplines and research fields, including the philosophy of science, epidemiology, statistics and ethics. The contributions were originally presented at the 1st Barcelona conference of “Philosophy of Public Health”. This book is intended for researchers interested in public health and the contemporary debates surrounding it.

To analyze which ethically relevant biases have been identified by academic literature in artificial intelligence algorithms developed either for patient risk prediction and triage, or for contact tracing to deal with the COVID-19 pandemic. Additionally, to specifically investigate whether the role of social determinants of health have been considered in these AI developments or not. We conducted a scoping review of the literature, which covered publications from March 2020 to April 2021. ​Studies mentioning biases on AI algorithms developed for contact (...) tracing and medical triage or risk prediction regarding COVID-19 were included. From 1054 identified articles, 20 studies were finally included. We propose a typology of biases identified in the literature based on bias, limitations and other ethical issues in both areas of analysis. Results on health disparities and SDOH were classified into five categories: racial disparities, biased data, socio-economic disparities, unequal accessibility and workforce, and information communication. SDOH needs to be considered in the clinical context, where they still seem underestimated. Epidemiological conditions depend on geographic location, so the use of local data in studies to develop international solutions may increase some biases. Gender bias was not specifically addressed in the articles included. The main biases are related to data collection and management. Ethical problems related to privacy, consent, and lack of regulation have been identified in contact tracing while some bias-related health inequalities have been highlighted. There is a need for further research focusing on SDOH and these specific AI apps. (shrink)

The main aim of this article is to reflect on the impact of biases related to artificial intelligence (AI) systems developed to tackle issues arising from the COVID-19 pandemic, with special focus on those developed for triage and risk prediction. A secondary aim is to review assessment tools that have been developed to prevent biases in AI systems. In addition, we provide a conceptual clarification for some terms related to biases in this particular context. We focus mainly on nonracial biases (...) that may be less considered when addressing biases in AI systems in the existing literature. In the manuscript, we found that the existence of bias in AI systems used for COVID-19 can result in algorithmic justice and that the legal frameworks and strategies developed to prevent the apparition of bias have failed to adequately consider social determinants of health. Finally, we make some recommendations on how to include more diverse professional profiles in order to develop AI systems that increase the epistemic diversity needed to tackle AI biases during the COVID-19 pandemic and beyond. (shrink)

The research project of common sense or folk behavior for the specific purposes of advancing epistemology has quickly become one of the largest in experimental philosophy. This chapter explains some of this work as it relates to two positions in epistemology: contextualism and interest relative invariantism (IRI). Naturally, questions arise about the relevance of folk behavior to debates in epistemology. First, there is the dialectical issue concerning the extent to which epistemologists have in fact relied on ordinary behavior in defending (...) their theories. Second, in the cases where epistemologists have made such appeals, people can ask if they have been correct in doing so. And third, assuming correctness in this regard, there is a question about which experimental methods, if any, are pertinent for understanding folk behavior. It is taken takes for granted that epistemologists appeal to ordinary usage and that their doing so in fact informs epistemology. (shrink)

The Midewiwin is the traditional religious belief system central to the world view of Ojibwa in Canada and the US. It is a highly complex and rich series of sacred teachings and narratives whose preservation enabled the Ojibwa to withstand severe challenges to their entire social fabric throughout the 19th and 20th centuries. It remains an important living and spiritual tradition for many Aboriginal people today. The rituals of the Midewiwin were observed by many 19th century Euro-Americans, most of whom (...) approached these ceremonies with hostility and suspicion. As a result, although there were many accounts of the Midewiwin published in the 19th century, they were often riddled with misinterpretations and inaccuracies. Historian Michael Angel compares the early texts written about the Midewiwin, and identifies major, common misconceptions in these accounts. In his explanation of the historical role played by the Midewiwin, he provides alternative viewpoints and explanations of the significance of the ceremonies, while respecting the sacred and symbolic nature of the Midewiwin rituals, songs, and scrolls. (shrink)

This study investigates the relationship between mental health and emotional intelligence among senior high school students in a public school. Thus, the study employed a correlational design to measure the relationship between mental health and emotional intelligence among 152 Grade 12 senior high school students in a public school. Hence, to measure the study’s variables - Mental Health Inventory and Emotional Intelligence Scale (EIS) were utilized. Based on the inferential statistics, the r coefficient of 0.32 indicates a low positive correlation (...) between the variables and a p-value of 0.00, indicating a significant relationship between the respondents' mental health and emotional intelligence. Implications and recommendations were discussed in the study. (shrink)

Sometimes two expressions in a discourse can be about the same thing in a way that makes that very fact evident to the participants. Consider, for example, 'he' and 'John' in 'John went to the store and he bought some milk'. Let us call this 'de jure' coreference. Other times, coreference is 'de facto' as with 'Mark Twain' and 'Samuel Clemens' in a sincere use of 'Mark Twain is not Samuel Clemens'. Here, agents can understand the speech without knowing that (...) the names refer to the same person. After surveying many available linguistic and pragmatic tools (intentions to corefer, presuppositions, meanings, indexing, discourse referents, binding etc.) I conclude that we must posit a new semantic primitive to account for de jure coreference. (shrink)

Because of the COVID-19 pandemic, procrastination has become commonplace due to changes in teaching and learning, which trigger students' academic burnout. As a result, it has increased the intensity of procrastination among students who are enrolled in online learning programs. As a result, students have difficulty as a result of the rapid change from in-person learning to online learning. The study investigates the relationship between academic burnout and procrastination among 150 grade 12 senior high school students. Hence, this study employed (...) a correlational design. Based on the inferential analysis, the r coefficient of 0.71 indicates a high positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision to reject the null hypothesis. Hence, a significant relationship exists between academic burnout and academic procrastination among grade 12 senior high school students. (shrink)

Recently, some philosophers have defended the idea that knowledge is an interest-relative notion. According to this thesis, whether an agent knows P may depend on the practical costs of her being wrong about P. This perspective marks a radical departure from traditional accounts that take knowledge to be a purely intellectual concept. I think there is much to say on behalf of the interest-relative notion. In this paper, I report on some new evidence which strongly suggests that ordinary people’s attributions (...) of knowledge are in fact sensitive to practical interests. This is noteworthy because recent experiments have been interpreted by many to support the opposite conclusion. I also argue that the new results support an invariantist but interest-relativist account of knowledge, a thesis known as Interest Relative Invariantism (IRI). I do not make the case here that IRI gives us the very best explanation of the results presented here. Any such attempt would require an in-depth survey of the last few decades of work in epistemology. I only want to argue here that IRI gives us a simple and elegant explanation of the new data, and that the same cannot be said about traditional contextualism, a leading competitor to IRI. (shrink)

There has been longstanding interest in the consistency of decisions made by research ethics committees in the UK, but most of the evidence has come from single studies submitted to multiple committees. A systematic comparison was carried out of the decisions made on 18 purposively selected applications, each of which was reviewed independently by three different RECs in a single strategic health authority. Decisions on 11 applications were consistent, but disparities were found among RECs on decisions on seven applications. An (...) analysis of the agreement between decisions of RECs yielded an overall measure of agreement of κ = 0.286 , indicating a level of agreement that, although probably better than chance, may be described as “slight”. The small sample size limits the robustness of these findings. Further research on reasons for inconsistencies in decision making between RECs, and on the importance of such inconsistencies for a range of arguments, is needed. (shrink)

Big Data evangelists often argue that algorithms make decision-making more informed and objective—a promise hotly contested by critics of these technologies. Yet, to date, most of the debate has focused on the instruments themselves, rather than on how they are used. This article addresses this lack by examining the actual practices surrounding algorithmic technologies. Specifically, drawing on multi-sited ethnographic data, I compare how algorithms are used and interpreted in two institutional contexts with markedly different characteristics: web journalism and criminal justice. (...) I find that there are surprising similarities in how web journalists and legal professionals use algorithms in their work. In both cases, I document a gap between the intended and actual effects of algorithms—a process I analyze as “decoupling.” Second, I identify a gamut of buffering strategies used by both web journalists and legal professionals to minimize the impact of algorithms in their daily work. Those include foot-dragging, gaming, and open critique. Of course, these similarities do not exhaust the differences between the two cases, which are explored in the discussion section. I conclude with a call for further ethnographic work on algorithms in practice as an important empirical check against the dominant rhetoric of algorithmic power. (shrink)

A common theme in social science studies of algorithms is that they are profoundly opaque and function as “black boxes.” Scholars have developed several methodological approaches in order to address algorithmic opacity. Here I argue that we can explicitly enroll algorithms in ethnographic research, which can shed light on unexpected aspects of algorithmic systems—including their opacity. I delineate three meso-level strategies for algorithmic ethnography. The first, algorithmic refraction, examines the reconfigurations that take place when computational software, people, and institutions interact. (...) The second strategy, algorithmic comparison, relies on a similarity-and-difference approach to identify the instruments’ unique features. The third strategy, algorithmic triangulation, enrolls algorithms to help gather rich qualitative data. I conclude by discussing the implications of this toolkit for the study of algorithms and future of ethnographic fieldwork. (shrink)

Research Ethics Committees (RECs) are frequently a focus of complaints from researchers, but evidence about the operation and decisions of RECs tends to be anecdotal. We conducted a systematic study to identify and compare the ethical issues raised in 54 letters to researchers about the same 18 applications submitted to three RECs over one year. The most common type of ethical trouble identified in REC letters related to informed consent, followed by scientific design and conduct, care and protection of research (...) participants, confidentiality, recruitment and documentation. Community considerations were least frequently raised. There was evidence of variability in the ethical troubles identified and the remedies recommended. This analysis suggests that some principles may be more institutionalized than others, and offers some evidence of inconsistency between RECs. Inconsistency is often treated as evidence of incompetence and caprice, but a more sophisticated understanding of the role of RECs and their functioning is required. (shrink)

The production of good sound generation in the violin is a complex task that requires coordination and spatiotemporal control of bowing gestures. The use of motion-capture technologies to improve performance or reduce injury risks in the area of kinesiology is becoming widespread. The combination of motion accuracy and sound quality feedback has the potential of becoming an important aid in violin learning. In this study, we evaluate motion-capture and sound-quality analysis technologies developed inside the context of the TELMI, a technology-enhanced (...) music learning project. We analyzed the sound and bow motion of 50 participants with no prior violin experience while learning to produce a stable sound in the violin. Participants were divided into two groups: the experimental group received real-time visual feedback both on kinematics and sound quality, while participants in the control group practiced without any type of external help. An additional third group of violin experts performed the same task for comparative purposes. After the practice session, all groups were evaluated in a transfer phase without feedback. At the practice phase, the experimental group improved their bowing kinematics in comparison to the control group, but this was at the expense of impairing the sound quality of their performance. At the retention phase, the experimental group showed better results in sound quality, especially concerning control of sound dynamics. Besides, we found that the expert group improved the stability of their sound while using the technology. All in all, these results emphasize the importance of feedback technologies in learning complex tasks, such as musical instrument learning. (shrink)

Este artículo tiene como objetivo, asumir desde Colombia y América Latina,el texto más renombrado del filósofo alemánWalter Benjamin: Tesis sobre elConcepto de Historia. En mi interpretación, el tiempo histórico incluye larevolución, que Benjamin sitúa en la tradición de Marx y en la “Liga Espartaco” de Alemania, para reivindicar plenamente a los vencidos y excluidos.

Two prevailing accounts of the structure of the mind have been provided, respectively, by the Dual System Theory and by the Massive Modularity Hypothesis. It has been claimed, however, that they cannot both be true at the same time, i.e., that they are incompatible and, thus, that one of them must be abandoned. I will offer some arguments to challenge this claim. I will show that a plausible understanding of each theory makes it possible for them both to be true (...) at the same time. Moreover, I will argue that by appealing to each other they can offer a more complete and detailed account of the architecture of the mind. (shrink)

In this essay, I argue that pronatalism—a social bias in favor of gestational motherhood—and geneticism—a social bias in favor of genetic motherhood—are conceptually and operationally distinct social forces that influence some women's reproductive decision making. Each of these social forces shapes the reproductive landscape, relates differently to women's identities, and causes different social stigmatization and harm. Pronatalism and geneticism warrant feminist concern because they can compromise some women's reproductive autonomy and well-being. I suggest that combating pronatalism and geneticism will require (...) different sets of media, policy, education, and health care practice strategies. (shrink)

In this paper, I propose and defend a pair of necessary conditions on evidence-based knowledge which bear resemblance to the troubled sensitivity principles defended in the philosophical literature. We can think of the traditional principles as simple but inaccurate approximations of the new proposals. Insofar as the old principles are intuitive and used in scientific and philosophical contexts, but are plausibly false, there’s a real need to develop precise and correct formulations. These new renditions turned out to be more cautious, (...) so they won’t be able to do everything the old principled promised they could. For example, they respect closure for knowledge. But these sober formulations, or something like them, might be the best that we can do with respect to sensitivity. And there’s value in understanding the limits to these types of principles. (shrink)

This event-related potential (ERP) study examined the impact of phonological variation resulting from a vowel merger on phoneme perception. The perception of the /e/–/ε/ contrast which does not exist in Southern French-speaking regions, and which is in the process of merging in Northern French-speaking regions, was compared to the /ø/–/y/ contrast, which is stable in all French-speaking regions. French-speaking participants from Switzerland for whom the /e/–/ε/ contrast is preserved, but who are exposed to different regional variants, had to perform a (...) same-different task. They first heard four phonemically identical but acoustically different syllables (e.g., /be/–/be/–/be/–/be/), and then heard the test syllable which was either phonemically identical to (/be/) or phonemically different from (/bε/) the preceding context stimuli. The results showed that the unstable /e/–/ε/ contrast only induced a mismatch negativity (MMN), whereas the /ø/–/y/ contrast elicited both a MMN and electrophysiological differences on the P200. These findings were in line with the behavioral results in which responses were slower and more error-prone in the /e/–/ε/ deviant condition than in the /ø/–/y/ deviant condition. Together these findings suggest that the regional variability in the speech input to which listeners are exposed affects the perception of speech sounds in their own accent. (shrink)

En las siguientes líneas se comparte una reflexión sobre la importancia, el sen- tido y la vigencia que tiene la bioética social en nuestros días. Si bien es cierto que con frecuencia el término bioética se relaciona con cuestiones de problemas y dilemas de ética clínica al interior de hospitales, así como con la defensa de los animales no humanos y el medio ambiente, la bioética tiene una cuña de intervención social con grupos de personas vulneradas en sus derechos o (...) que, por su condición, han sido socialmente invisibilizados. Por tal motivo, se pro- pone la inclusión de la bioética social como una herramienta de intervención educativa en sectores marginados o excluidos, y como mecanismo que permita el empoderamiento de las personas que pertenecen a estos grupos, a partir de los principios y nociones con los que trabaja la disciplina. (shrink)

Children and adults use established global knowledge to generate real‐time linguistic predictions, but less is known about how listeners generate predictions in circumstances that semantically conflict with long‐standing event knowledge. We explore these issues in adults and 5‐ to 10‐year‐old children using an eye‐tracked sentence comprehension task that tests real‐time activation of unexpected events that had been previously encountered in brief stories. Adults generated predictions for these previously unexpected events based on these discourse cues alone, whereas children overall did not (...) override their established global knowledge to generate expectations for semantically conflicting material; however, they do show an increased ability to integrate discourse cues to generate appropriate predictions for sentential endings. These results indicate that the ability to rapidly integrate and deploy semantically conflicting knowledge has a long developmental trajectory, with adult‐like patterns not emerging until later in childhood. (shrink)