The COVID-19 vaccine has been a miraculous, life-saving advance, offering staggering efficacy in adults, and was developed with astonishing speed. The time from sequencing the virus to authorizing the first COVID-19 vaccine was so brisk even the optimists appear close-minded. Yet, simultaneously, United States’ COVID-19 vaccination roll-out and related policies have contained missed opportunities, errors, run counter to evidence-based medicine, and revealed limitations in the judgment of public policymakers. Misplaced utilization, contradictory messaging, and poor deployment in those who would benefit (...) most—the elderly and high-risk—alongside unrealistic messaging, exaggeration, and coercion in those who benefit least—young, healthy Americans—is at the heart. It is important to consider the history of COVID-19 vaccines to identify where we succeeded and where we failed, and the effects that these errors may have more broadly on vaccination hesitancy and routine childhood immunization programs in the decades to come. (shrink)

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise—i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention—has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always (...) justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions. (shrink)

Many physicians are involved in relationships that create tension between a physician's duty to work in her patients’ best interest at all times and her financial arrangement with a third party, most often a pharmaceutical manufacturer, whose primary goal is maximizing sales or profit. Despite the prevalence of this threat, in the United States and globally, the most common reaction to conflicts of interest in medicine is timid acceptance. There are few calls for conflicts of interest to be banned, and, (...) to our knowledge, no one calls for conflicted practitioners to be reprimanded. Contrast our attitudes in medicine with public attitudes toward financial conflicts among government employees. When enforcement of rules against conflict of interest slackens in the public sector, news organizations investigate and publish their criticism. Yet even when doctors are quoted in the media promoting specific drugs, their personal financial ties to the drug maker are rarely mentioned. Policies for governmental employees are strict, condemnation is strong, and criminal statutes exist (allowing for corruption charges). Yet the evidence that conflict is problematic is, if anything, stronger in medicine than in the public sector. Policies against conflicts of interest in medicine should be at least as strong as those already existing in the public sector. (shrink)

The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of (...) novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA. In recent years, across a series of diverse publications, the financial conflicts of interest of each category of participants in the meetings have been investigated. Here, we summarize these findings and their ethical implications, focusing on the FDA Oncologic Drugs Advisory Committee, and we suggest ways to move toward more transparent and impartial advisory committee meetings. (shrink)

Many physicians are involved in relationships that create tension between a physician's duty to work in her patients’ best interest at all times and her financial arrangement with a third party, most often a pharmaceutical manufacturer, whose primary goal is maximizing sales or profit. Despite the prevalence of this threat, in the United States and globally, the most common reaction to conflicts of interest in medicine is timid acceptance. There are few calls for conflicts of interest to be banned, and, (...) to our knowledge, no one calls for conflicted practitioners to be reprimanded. Contrast our attitudes in medicine with public attitudes toward financial conflicts among government employees. When enforcement of rules against conflict of interest slackens in the public sector, news organizations investigate and publish their criticism. Yet even when doctors are quoted in the media promoting specific drugs, their personal financial ties to the drug maker are rarely mentioned. Policies for governmental employees are strict, condemnation is strong, and criminal statutes exist. Yet the evidence that conflict is problematic is, if anything, stronger in medicine than in the public sector. Policies against conflicts of interest in medicine should be at least as strong as those already existing in the public sector. (shrink)

In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...) 18.5 serious adverse events from mRNA vaccines, including 1.5–4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates. (shrink)

We thank Leo Lam and Taylor Nichols for their response 1 to our paper ‘COVID-19 vaccine boosters for young adults: a risk–benefit assessment and ethical analysis of mandate policies at universities’. 2 In our paper, we demonstrate that the risk–benefit calculus to mandate boosters for young adults aged 18–29 is a net risk intervention. The authors assert that we have made three inappropriate comparisons of benefits versus risks of the mRNA vaccine booster dose in this age group. We provide our (...) response to each below. We erred on the side of overestimating benefits of the booster dose against severe COVID-19 in this age group and still found net harms to outweigh net benefits. The conclusion of our paper holds, and university booster mandates for young people were—and remain—unethical. COVID-19 hospitalisations prevented versus booster serious adverse events (SAEs) For the first comparison, we weighed predicted hospitalisations prevented... (shrink)

pt. 1. Character development -- pt. 2. Training at NDA, IMA & OTA -- pt. 3. Army pt tests -- pt. 4. Leadership development -- pt. 5. Positive development -- pt. 6. Author's reminiscences.

Based on original translations of passages from the works of three major thinkers of the classical Indian school of Advaita (Sankara, Vacaspati and Sri Harsa), but addressing issues found in Descartes, Berkeley, Hume, Kant, Wittgenstein and contemporary analytic philosophers, this book argues for a philosophical position it calls 'non-realism'. This is the view that an independent, external world must be assumed if the features of cognition are to be explained, but that it cannot be proved that there is such a (...) world, independently of an appeal to cognition itself. This position is constructed against idealist denials of externality, realist arguments for an independent world and the sceptical denial of the coherence of cognition. (shrink)

Text document classification and clustering is an important learning task which fits to both data mining and machine learning areas. The learning task throws several challenges when it is required to process high dimensional text documents. Word distribution in text documents plays a very key role in learning process. Research related to high dimensional text document classification and clustering is usually limited to application of traditional distance functions and most of the research contributions in the existing literature did not consider (...) the word distribution in documents. In this research, we propose a novel similarity function for feature pattern clustering and high dimensional text classification. The similarity function proposed is used to carry supervised learning based dimensionality reduction. The important feature of this work is that the word distribution before and after dimensionality reduction is the same. Experiment results prove the proposed approach achieves dimensionality reduction, retains the word distribution and obtained better classification accuracies compared to other measures. (shrink)

In this paper a new technique of dual image watermarking is proposed for protection of ownership rights which utilizes salient properties of homomorphic transform (HT), discrete wavelet transform (DWT), singular value decomposition (SVD) and Arnold transform (AT). In embedding algorithm host image is splitted into reflectance and illumination components using HT, DWT is further applied to the reflectance component resulting in frequency subbands (HL and LH) which are transformed by SVD. Two image watermarks are selected for embedding process whereas security (...) of proposed algorithm is strengthen by performing scrambling of second watermark through AT. Both watermarks are transformed with DWT and SVD. Singular values (SVs) of both transformed watermark are embedded into SVs of host image. Simulation results clearly signifies for high robustness and imperceptibility of proposed algorithm as it is examined under various attacks. Superiority of proposed technique is illustrated by comparing it with other reported methods. (shrink)

Religion of the Rabaris of the Rajasthan, India; a study.

This Work Analyses Some Basic Concepts Of Indian Ethics. It Shows That A Varnadharma Cannot Be Both Natural And Obligatory, The Prescription Of Acting Desirelessly Makes Any Desireless Action Justified, The Jivan-Mukti Concept Is Inapplicable, Etc.

On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care and preventable deaths. In order to be prepared for (...) this challenging situation, national triage guidance has been developed or adapted from former influenza pandemic guidelines in an increasing number of countries over the past few months. In this article, we provide a comparative analysis of triage recommendations from selected national and international professional societies, including Australia/New Zealand, Belgium, Canada, Germany, Great Britain, Italy, Pakistan, South Africa, Switzerland, the United States, and the International Society of Critical Care Medicine. We describe areas of consensus, including the importance of prognosis, patient will, transparency of the decision‐making process, and psychosocial support for staff, as well as the role of justice and benefit maximization as core principles. We then probe areas of disagreement, such as the role of survival versus outcome, long‐term versus short‐term prognosis, the use of age and comorbidities as triage criteria, priority groups and potential tiebreakers such as ‘lottery’ or ‘first come, first served’. Having explored a number of tensions in current guidance, we conclude with a suggestion for framework conditions that are clear, consistent and implementable. This analysis is intended to advance the ongoing debate regarding the fair allocation of limited resources and may be relevant for future policy‐making. (shrink)

This essay draws attention to some of the ideas and discussions in the classical Advaita Vedantic literature that have a direct bearing on contemporary debates concerning the existence of consciousness in the empirical world. Section 1 makes the case for pursuing a non-eliminativist reading of Advaita Vedanta by clarifying its position on the existence of the empirical world. The idea here is to lay the background for approaching Advaita Vedanta from a cosmopsychist perspective. Section 2 shows, first, how the position (...) of Advaita Vedanta that macro-level consciousnesses are reflections of the universal consciousness (Brahman) in the intellects ( buddhi ) of empirical selves sets it apart from the prevailing cosmopsychist theories. It then goes on to discuss how this idea of reflection can at once offer an elegant solution to the decombination/derivation problem, suggest a promising way to bridge "the explanatory gap" and explain the phenomena of mental causation. (shrink)

This book, through extensive textual study, explores the Buddha's and Buddhism's uncompromising and unflinching emphasis on the centrality of ethics as against any pernicious dogmas and metaphysical beliefs, and their attempts to causally relate moral perfection to soteriological or eschatological goal. What is most admirable about Buddhism is that it integrates the vertical development of human consciousness, for which the other is the necessary condition, with the gradual development of morality. It was this emphasis which separated Siddhartha, before he attained (...) the Awakened Wisdom (bodhi), from his teachers - Alara Kalama and Uddaka Ramaputta - and it is for this reason that the Buddha calls himself and his Dhamma Patisotagami, i.e. going against the currents of the prevailing dogmas and pernicious beliefs. In brief, Buddhism is about overcoming of suffering, the greatest evil, through ethicization of human consciousness and conduct, which also takes care of the ethicization of the society and the universe. Besides, some of the essays of this book explore many other themes like Buddhist epistemology, nature of self, time, and intercultural. (shrink)

The Limits of Scripture: Vivekananda's Reinterpretation of the Vedas by Anantanand Rambachan has been a pathbreaking work for initiating a critical examination of Swami Vivekananda's epistemological teachings. Rambachan challenges the trend adopted by some modern commentators to equate the teachings of Śaṅkara and Vivekananda. He observes that they overlook the "[f]undamental differences" between the two and present the latter "merely as a reviver of the Advaita of Śaṅkara."1 Opposing the trend, Rambachan follows Paul Hacker in projecting Vivekananda as a proponent (...) of "neo-Hinduism"2 as distinct from the traditional Hinduism.3 He argues that while Śaṅkara regards the Vedas as a "unique and self-valid... (shrink)

I am thankful to Professor Rambachan for responding to my comments. First of all, I retract my statement where I call one of the author's remarks to be a mocking of Swami Vivekananda's view. I apologize for this or any other comment that might project the author to be hostile toward Vivekananda. Some words are due regarding Rambachan's objection to my comparison of his work with that of Paul Hacker. Rambachan's questioning of the "continuity between neo-Vedānta and its classical roots" (...) is the reason that led me to compare his study with Hacker's neo-Vedānta thesis, which makes a similar argument.1It is not unreasonable to think that according to Rambachan Vivekananda's deviation from Śaṅkara was effected by factors... (shrink)

Cognitive architectures, like programming languages, make commitments only at the implementation level and have limited explanatory power. Their universality implies that it is hard, if not impossible, to justify them in detail from finite quantities of data. It is more fruitful to focus on particular tasks such as language understanding and propose testable theories at the computational and algorithmic levels.

This article presents material from my ethnographic study in Śringēri, south India, the site of a powerful 1200yearold Advaitic monastery that has been historically an interpreter of ancient Hindu moral treatises. A vibrant diverse local culture that provides plural sources of moral authority makes Sringeri a rich site for studying moral discourse. Through a study of two conversational narratives, this essay illustrates how the moral self is not an ossified product of written texts and codes, but is dynamic, gen dered, (...) and emergent, endowed with historical and political agency and an aesthetic capacity that mediates many normative sources to articulate "appropriate" conduct. In so doing, the essay shows the value of including oral narrative in ethical inquiry, especially in narrative ethics, which, for most part, has focused on written sources. (shrink)

Introduction: The coronavirus disease 2019 pandemic has placed intensive care units (ICU) triage at the center of bioethical discussions. National and international triage guidelines emerged from professional and governmental bodies and have led to controversial discussions about which criteria—e.g. medical prognosis, age, life-expectancy or quality of life—are ethically acceptable. The paper presents the main points of agreement and disagreement in triage protocols and reviews the ethical debate surrounding them. Sources of data: Published articles, news articles, book chapters, ICU triage guidelines (...) set out by professional societies and health authorities. Areas of agreement: Points of agreement in the guidelines that are widely supported by ethical arguments are (i) to avoid using a first come, first served policy or quality-adjusted life-years and (ii) to rely on medical prognosis, maximizing lives saved, justice as fairness and non-discrimination. Areas of controversy: Points of disagreement in existing guidelines and the ethics literature more broadly regard the use of exclusion criteria, the role of life expectancy, the prioritization of healthcare workers and the reassessment of triage decisions. Growing points: Improve outcome predictions, possibly aided by Artificial intelligence (AI); develop participatory approaches to drafting, assessing and revising triaging protocols; learn from experiences with implementation of guidelines with a view to continuously improve decision-making. Areas timely for developing research: Examine the universality vs. context-dependence of triaging principles and criteria; empirically test the appropriateness of triaging guidelines, including impact on vulnerable groups and risk of discrimination; study the potential and challenges of AI for outcome and preference prediction and decision-support. (shrink)

Vedānta endeavours to base itself essentially on the facts of experience—in the fullest sense of the term. It recognizes the occurrence of everyday experience and the so-called fact of evil, but it refuses to view them as real. The real, it says, like Hegel, does not exist, and that which exists is not real. Evil is only an “existent"—as all this Samsara is—but not the ultimate Real. But it will be at once objected that if evil is an appearance, a (...) Maya, why should this appearance appear at all? If it has no foundation in reality, how and why does it occur at all? Further, how can anything be known as real unless it should appear ? Reality must appear. (shrink)

Chakravarthi Ram-Prasad offers illuminating new perspectives on contemporary phenomenological theories of body and subjectivity, based on studies of diverse classical Indian texts. He argues for a 'phenomenological ecology' of bodily subjectivity in health, gender, contemplation, and lovemaking.

Man is endowed with brain and mind for comprehending reality of the world. Brain is material entity and is observable, while mind is a non-physical conceived entity. Scientific investigations enhance our knowledge of the functioning of brain and its constituents. They indicate mind-brain association but do not rule out the possibility, in which mind is a property of brain. The perceived reality of the world has both objective and subjective components. The objective components are attributed to brain either alone or (...) in association with mind. The subjective components are considered to be the creations of mind but they appear to contain grains of reality. Attempts made to separate these grains have succeeded partially. One hopes for complete success only after the incorporation of a few missing ingredients. It is our contention that the missing ingredients are human being as an entangled quantum entity - photon field, quantum entity's capability to read information from photon fields of other humans and from its own field reflected by the environment. The evidence for the first ingredient is provided by the analysis of spontaneously emitted visible range photon signals by human beings. The other two ingredients put usual charge- photon interaction in proper context. The experimental results relevant to mind- brain interface are briefly described. A few minutes' time series of small portion of these signals determines their nine properties, which establish quantum nature of signal, and specify quantum state of the dominant component to be squeezed state. Six properties differ in signals emitted at 12 anatomical sites of the same person. Profile of a property for a person is the set of its values at 12 sites. Profile is very informative and can discriminate persons with differing holistic features. Cluster analysis offers procedures for measuring qualitative holistic features e.g. procedure for measuring ‘meditativeness' of a person. The incorporation of other two ingredients chalks out a route for answering the question who we are? (shrink)

This paper deals with issues related to character building and human values, both in personal and work life. The focus of the author is value-centred management, which has been discussed along two aspects of the human self, that is, the micro self and macro self. Here, the author tries to highlight the importance of both 'selves' in the organizational context. In the concluding part of the paper the author presents the authenticity of Kautilya's views on the macro self in the (...) context of the present business scenario. The author attempts to portray the transition created by the market economy, which cannot provide an exclusively painless solution. Moreover, he advocates culturing of self-discipline in corporate life, which can bring about qualitative improvement, both in work and personal life. 'Work with integrity and serve with love' is the philosophy the author presents in this paper. (shrink)