An absolute decline in US life expectancy in low education whites has alarmed policy makers and attracted media attention. Depending on which studies are correct, low education white women have lost between 3 and 5 years of lifespan; men, between 6 months and 3 years. Although absolute declines in life expectancy are relatively rare, some commentators see the public alarm as reflecting a racist concern for white lives over black ones. How ought we ethically to evaluate this lifespan contraction in (...) low education whites? Should we care, or is it racist to care? Does it constitute an injustice or reflect justice being done? I argue that the lifespan contraction in low education whites violates key normative criteria used to make determinations of health justice, and that these judgments do not vitiate concerns about racism. I conclude with reflections on US population health policy and building an inclusive health equity movement. (shrink)

Background This paper describes the design, implementation, and process outcomes from three public deliberations held in three tribal communities. Although increasingly used around the globe to address collective challenges, our study is among the first to adapt public deliberation for use with exclusively Indigenous populations. In question was how to design deliberations for tribal communities and whether this adapted model would achieve key deliberative goals and be well received.Methods We adapted democratic deliberation, an approach to stakeholder engagement, for use with (...) three tribal communities to respect tribal values and customs. Public deliberation convenes people from diverse backgrounds in reasoned reflection and dialogue in search of collective solutions. The deliberation planning process and design were informed by frameworks of enclave deliberation and community-based participatory research, which share key egalitarian values. The deliberations were collaboratively designed with tribal leadership and extensive partner input and involvement in the deliberations. Each deliberation posed different, locally relevant questions about genomic research, but used the same deliberation structure and measures to gauge the quality and experience of deliberation.Results A total of 52 individuals participated in the deliberations across all three sites. Deliberants were balanced in gender, spanned decades in age, and were diverse in educational attainment and exposure to health research. Overall, the deliberations were positively evaluated. Participant perceptions and external observer datasets depict three deliberations that offered intensive conversation experiences in which participants learned from one another, reported feeling respected and connected to one another, and endorsed this intensive form of engagement.Conclusion The adapted deliberations achieved key deliberative goals and were generally well received. Limitations of the study are described. (shrink)

Critics from a variety of camps have argued that bioethics has suffered an indifference to Cases have been described as thin and the selves inhabiting them hollow. This criticism has been driven at least in part by a reworked conception of the self. The rational and autonomous self that once dominated bioethics discourse has been replaced with a more self, a self embedded in stories, relationships, families, communities, cultures, and other particularitythese differences—matter. They matter because they figure importantly into our (...) ethical analyses of cases, affecting, for example, how we interact with and treat patients. And with this shift has come increasing attention to the processes of moral inquiry that enable inquirers to gather all of this moral information and find their way from complex cases to context-sensitive responses. (shrink)

Book reviewed in this article: Reshaping the Female Body: The Dilemma of Cosmetic Surgery. By Kathy Davis.

Empirical evidence demonstrates that minority and marginalized populations receive less and lower quality healthcare than more advantaged groups. Ethical analyses of these disparities explain their injustice. That disparities exist and constitute a moral wrong are uncontroversial views. Less clear are the exact causes of healthcare disparities.

Persons of low socioeconomic status generallyexperience worse health and shorter lives thantheir better off counterparts. They alsosuffer a greater incidence of adversepsychosocial characteristics, such as lowself-esteem, self-efficacy, and self-masteryand increased cynicism and hostility. Thesepopulation data suggest another category ofharm to persons: diminished moral agency. Chronic socioeconomic deprivation can createenvironments that undermine the development ofself and capacities constitutive to moralagency – i.e., the capacity forself-determination and crafting a life of one''sown. The harm affects not only the choicesa person makes, but the (...) chooser herself. Thismoral harm is particularly salient in modernWestern societies, especially in the UnitedStates, where success and failure is attributedto the individual, with little notice of thelarger social and political realities thatinform an individual''s circumstances and choices. (shrink)

Childhood obesity may have severe long‐term consequences for health—indeed, for the overall course of a person's life. Do these harms amount to a problem of social justice? And if so, what should be done about it? Parents are usually granted considerable leeway to make decisions that affect their children's health. Social and moral theory has often overlooked the family, however, leaving us with an inadequateunderstanding of parental autonomy and of how social policy may influence it.

Childhood obesity may have severe long-term consequences for health—indeed, for the overall course of a person's life. Do these harms amount to a problem of social justice? And if so, what should be done about it? Parents are usually granted considerable leeway to make decisions that affect their children's health. Social and moral theory has often overlooked the family, however, leaving us with an inadequate understanding of parental autonomy and of how social policy may influence it.

This essay argues that a failure to think and talk critically and candidly about White privilege and White poverty is a key threat to the United States of America's precarious democracy. Whiteness frames one of America's most pressing collective challenges—the poor state of the nation's health, which lags behind other wealthy nations and is marred by deep and entrenched class‐ and race‐based inequities. The broadscale remedies experts recommend demand what is in short supply: trust in evidence, experts, government, and one (...) another. The authors’ prescription is threefold, beginning with a call for intersectional health studies and reports that avoid one‐dimensional misrepresentations of widespread health problems as simply Black or White problems. Second, there is the need for a “critical consciousness” about race and class. Lastly, the essay calls for widescale opportunities for Americans to engage in cross‐racial and cross‐class democratic conversations about their struggles and aspirations in search of common ground. (shrink)

Shift work is a fixture of our 24-hour economy, with approximately 18 per cent of workers in the USA engaging in shift work, many overnight. Since shift work has been linked to an increased risk for an array of serious maladies, including cardiometabolic disorders and cancer, and is done disproportionately by the poor and by minorities, shift work is a highly prevalent economic and occupational health disparity. Here we draw primarily on the state of science around shift work and breast (...) cancer to argue that shift work represents a public health threat serious enough to warrant a precautionary stance. We use the precautionary principle to advance our case and view it as a moral compass for shift work research, empowering public health to cast shift work within the domain of health disparities deserving action despite scientific uncertainty. With the precautionary principle, we call for a deliberative decision-making process and formation of a broad shift work research collaboration to protect the health of many millions who work at night. (shrink)

Among the greatest challenges to improving health is determining how cultural diversity should influence healthcare practices and organizations, public health measures, biomedical research, and community partnering. Important but seldom addressed are challenges for bioethicists.

Among the greatest challenges to improving health is determining how cultural diversity should influence healthcare practices and organizations, public health measures, biomedical research, and community partnering. Important but seldom addressed are challenges for bioethicists.

Book reviewed in this article: Reshaping the Female Body: The Dilemma of Cosmetic Surgery. By Kathy Davis.

Social work and bioethics are fields deeply committed to cross-disciplinary collaboration to do their respective work. While scholars and practitioners from both fields share a commitment to social justice and to respecting the dignity, integrity and the worth of all persons, the overlap between the fields, including shared values, has received little attention. The purpose of this article is to describe the ways in which greater collaboration between the two fields can broaden their scope, enrich their scholarship, and better ground (...) their practice. We describe the potential for realizing such benefits in two areas – health care ethics consultation and social inequalities in health – arguing that the fields both complement and challenge one another, making them ideal partners for the interdisciplinary inquiry and problem-solving so often called for today in health and health care. (shrink)

This paper focuses on Confucian formulations of personhood and the implications they may have for bioethics and medical practice. We discuss how an appreciation of the Confucian concept of personhood can provide insights into the practice of informed consent and, in particular, the role of family members and physicians in medical decision-making in societies influenced by Confucian culture. We suggest that Western notions of informed consent appear ethically misguided when viewed from a Confucian perspective.

In this chapter I will present, in a general way, Millikan's biosemantic theory of the phenomenon of intentionality. For this purpose, the text will take the following path. First, I will present the problem of intentionality and an overview of the dominant theories of intentional content during the twentieth century and part of the twenty-first century. Then, I will present a general version of Millikan's biosemantic theory, appearing in 1984, which will allow us to see what the relevance and originality (...) of his proposal consists in. Finally, in keeping with one of the central purposes of Las filósofas que nos formaron, I will share a brief interview that Millikan very kindly agreed to give for this publication, in which she tells us some non-theoretical aspects of her history as a philosopher. (shrink)

In Philosophy, it is well known that of the total faculty population, the proportion of women is significantly lower than men. This disproportion is odd for a discipline within the humanities; these numbers seem more compatible with what is found in STEM (Science, Technology, Engineering, Mathematics) careers. These proportions are in turn a product of the low female presence that exists from the previous levels of academic training in philosophy. What happens in the case of the philosophy student body? For (...) example, the report presented by BeeBee and Saul (2011), on women in philosophy in the United Kingdom, in the period 2008 and 2009, points out that in the first degrees of academic training, in the bachelor's degree, women occupy 45% of the student population, in the master's degree 38% and in the doctorate 35%. Thus, "it is notable that there is a reduction in the proportion of women from the bachelor's degree to the doctorate [...]. This has as a consequence that at the professional level women holding positions as professors represent only 19%" (BeeBee & Saul, 2011, p. 11). Recently, Torres González (2018), based on European Union studies, points out that in Spain, with respect to gender disparity in students, "the data yield as a result masculinized studies, where, contrary to what happens in the branch of the humanities to which it [philosophy] belongs, males outnumber females by 28 percentage points" (2018, p. 328). This disparity is reflected in philosophy at the professional level, "the indicators of vertical segregation show a reinforced glass ceiling, which presents one of the worst data of hierarchical discrimination in the university: the percentage of female professors in philosophy is 12% compared to 21% of female professors in higher education" (Idem). Although it is a fact that there are fewer women than men studying philosophy and, therefore, fewer women than men working professionally in this discipline, we do not yet have possible explanations for this phenomenon of gender disparity in the student body in philosophy. In some cases, even if the number of women entering the philosophy degree program is already low, the number of women graduating is even lower, which indicates that there is attrition along the way; the initial numbers of women entering the program tend to decrease by the time they graduate. Thus we come to the question that is the subject of this paper: What causes female students to drop out of the philosophy program? In this article we answer this question from the philosophy of science and supported by local empirical data, so we do not give a complete or even less exhaustive answer. We review two explanatory models that purport to answer the question of why there are fewer women in philosophy, both formatively and professionally. These are the Different Voices Model (DVM) and the Perfect Storm Model (PSM); we opt for the latter and give reasons for it. Regarding the empirical aspect of our research, our source of statistical data belongs to the undergraduate program in philosophy at the Facultad de Estudios Superiores Acatlán-UNAM, Mexico (FES Acatlán), obtained in the framework of the SWIP-Analytic Mexico workshops. Our analysis of these data shows that even when female students have better GPAs than male students and take fewer subjects while enrolled, female students graduate less than male students in the FES Acatlan degree program. (shrink)

Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022–2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating (...) which societal discourses social media users draw on to oppose strike action by nurses. Using a combination of corpus‐based approaches and discourse analysis, we identified five categories of opposition: (i) discourse discrediting nurses; (ii) discourse discrediting strikes by nurses; (iii) discourse on the National Health System; (iv) discourse about the fairness of strikers' demands and (v) discourse about potential harmful impact. Our findings show how social media users operationalise wider societal discourses about the nursing profession (e.g., associations with care, gender, vocation and sacrifice) as well as recent crises such as the Covid‐19 pandemic to justify their opposition. The results also provide valuable insights into misconceptions about nursing, strike action and patient harm, which can inform strategies for public communication. (shrink)

Women and men are biologically and reproductively dissimilar. This sexual distinctiveness gives rise to a “sexual asymmetry”—the fundamental reality that the potential consequences of sexual intercourse are far more immediate and serious for women than for men. Advocates of contraception and abortion sought to cure sexual asymmetry by decoupling sex from procreation, relieving women from the consequences of sex, and thus equalizing the sexual experiences of men and women. But efforts to suppress or reject biological difference have not relieved women (...) of the consequences of sex and the vulnerabilities of pregnancy, even as they have further relieved men. Although secular feminist responses to biological difference have served to exacerbate sexual asymmetry, Catholic teaching on abortion, sex, and marriage—even contraception—provides an authentically pro-woman cultural response. (shrink)

This study reflects on the ways in which children, during pandemic times, expressed themselves and came into contact with their teachers and classmates through Image-Letters, ways of saying and saying themselves to the world through audiovisual media. Sensible sharing of their daily lives were revealed by these media and made us think about the diverse childhood of this time. The theoretical framework that supported this work had the contribution of De Certeau regarding studies on everyday life, Walter Benjamin with his (...) writings on childhood experience, Sandra Corazza and Walter Kohan with their contributions to studies on contemporary childhoods and Virgínia Kastrup who supported us on to the cartography method, a methodological approach that allowed us to follow the research process. The objective of this work was to observe the ways in which children communicate through verbal-visual media and what type of content and everyday fragments they choose to share their experiences during the pandemic period.with the school institution. It is important to highlight that the dissemination of the images was authorized by the children and their guardians through a free and informed consent term, in compliance with the ethical principles of research with images of children. Furthermore, the images are available through QRcode and can be accessed through a smartphone camera. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 1-2, Page 164-188, June 2022.

As innovations in the field of vascular composite allotransplantation (VCA) progress, whole-eye transplantation (WET) is poised to transition from non-human mammalian models to living human recipients. Present treatment options for vision loss are generally considered suboptimal, and attendant concerns ranging from aesthetics and prosthesis maintenance to social stigma may be mitigated by WET. Potential benefits to WET recipients may also include partial vision restoration, psychosocial benefits related to identity and social integration, improvements in physical comfort and function, and reduced surgical (...) risk associated with a biologic eye compared to a prosthesis. Perioperative and postoperative risks of WET are expected to be comparable to those of facial transplantation (FT), and may be similarly mitigated by immunosuppressive protocols, adequate psychosocial support, and a thorough selection process for both the recipient and donor. To minimize the risks associated with immunosuppressive medications, the first attempts in human recipients will likely be performed in conjunction with a FT. If first-in-human attempts at combined FT-WET prove successful and the biologic eye survives, this opens the door for further advancement in the field of vision restoration by means of a viable surgical option. This analysis integrates recent innovations in WET research with the existing discourse on the ethics of surgical innovation and offers preliminary guidance to VCA programs considering undertaking WET in human recipients. (shrink)

Due to the variety of research ethics and integrity training formats it may be challenging to use a common instrument to monitor and evaluate the development of competencies and learning progress as well as determine the effectiveness of the training. The present study scrutinises the use of learning diaries as one possible measure to evaluate the development of ethics competencies. The aim of the study was to increase understanding about how learning diaries capture development of research ethics and integrity competencies (...) of participants and explore the use of diaries as a measure of training effectiveness. In the evaluative case study, a micro-credential programme was used as the context of the study and data was analysed using deductive content analysis. As a result, we outline criteria for analysis to be used in ethics training programmes for learning diaries. Results indicated that learning diaries submitted in the forum format (compared to individual submissions) provide peer support, so learners display more content knowledge on high levels of reflection and understanding. Submitting learning diaries over a longer period and making submissions repeatedly can improve writing and reflection competencies. The quality of learning diary entries may also depend on learner characteristics, such as commitment and motivation. Keeping a learning diary can help retain obtained competencies over a longer period. The article ends with a set of recommendations for implementing learning diaries as one measure of evaluation. (shrink)

: The main contribution of this paper to current philosophical and sociological studies on modeling is to analyze modeling as an object-oriented interdisciplinary activity and thus to bring new insights into the wide, heterogeneous discourse on tools, forms and organization of interdisciplinary research. A detailed analysis of interdisciplinarity in the making of models is presented, focusing on long-standing interdisciplinary collaboration between specialists in infectious diseases, mathematicians and computer scientists. The analysis introduces a novel way of studying the elements of the (...) models as carriers of interdisciplinarity. These elements, being functionally interdependent building blocks, evolve during the modeling work and carry the disciplinary tensions in the process. This shows how the long and challenging process of defining and reformulating the object of research is crucial for understanding the dynamics of interdisciplinarity in the making. (shrink)

This paper is going to explore the adverse effects of exposure to combat death on medics’ holistic well-being, which, if ignored could decrease individual readiness and negatively impact the mission. We rely on the experience of United States Air Force Special Operation Surgical Teams (AF SOST) whose exposure to mass casualty scenarios in austere environments could serve as approximations of conditions of future battlefields. Over the past two decades, the ability to deliver advanced medical care on and off the battlefield (...) along with a rapid casualty evacuation platform has allowed for unprecedented survival rates exceeding 90%. While laudable, these medical achievements have also set up a casualty management paradigm in which medical decision-making singularly focuses on life-saving care. Confronting peer-peer adversaries in large scale combat operations (LSCO) on a multi-domain battlefield will make casualty management frighteningly more complex by introducing major infrastructural, personnel, and resource constraints. When considering the high number of casualties expected in LSCO alongside enormous limitations in medical resource and resupply capability, the current casualty management paradigm will not be sustainable. The resource constrained environment in LSCO will shift medical decision-making away from a singular focus on life-saving care to triage, which hinges on the ability to determine futile medical interventions—a skill that has been lost in the past two generation of combat medics. As such, a broad ethical challenge that arises in preparation for LSCO is the need to set new expectations concerning dying and death. However, medical decision-making focused on death and dying has not been explicitly addressed in military medical training, research, or policy. Relying on a body of literature known as terror management theory (TMT) and ethnographic data from our study with AF SOST medics, we are going to argue that it is important to expose medics to death in mass casualty and triage training. (shrink)

Existing whistle-blowing models rely on “cold” economic calculations and cost-benefit analyses to explain the judgments and actions of potential whistle-blowers. I argue that “hot” cognitions – value conflict and emotions – should be added to these models. I propose a model of the whistle-blowing decision process that highlights the reciprocal influence of “hot” and “cold” cognitions and advocate research that explores how value conflict and emotions inform reporting decisions. I draw on the cognitive appraisal approach to emotions and on the (...) social-functional value pluralism model to generate propositions. (shrink)