The year 2020 is facing one of the worst public health situations in decades. The world is experiencing a pandemic that has triggered significant challenges to healthcare systems in both high and low‐middle income countries (LMICs). Government policymakers and healthcare personnel are experiencing real‐life ethical dilemmas and are pressed to respond to these situations. Many possible treatments are being investigated, one of which is the use of hydroxychloroquine or chloroquine. These drugs are approved for use by patients with systemic lupus (...) erythematosus (SLE), rheumatoid arthritis, and malaria. The demand for these products has increased, and the stocks are depleting for the patient population for whom the drugs are intended initially. Although both innovator and generic pharmaceutical manufacturers are making plans for increased production, there are challenges with global supply chains disruption and the retention of supplies for local markets. This may cause countries that rely on the importation of pharmaceuticals to be out of stock of supplies for an extended period. There are allegations of off‐label prescribing and hoarding. Pharmacists are the custodians and dispensers of medications and are faced with the task of assessing prescriptions and making decisions about the allocation of these products. This paper seeks to 1) highlight some of the ethical challenges of dispensing hydroxychloroquine by pharmacists during the COVID‐19 pandemic, 2) identify some of the responses to these issues from various regulatory authorities in the USA, and 3) recommend approaches to assist pharmacists in their decision‐making process, especially in LMICs. (shrink)

The year 2020 is facing one of the worst public health situations in decades. The world is experiencing a pandemic that has triggered significant challenges to healthcare systems in both high and low‐middle income countries (LMICs). Government policymakers and healthcare personnel are experiencing real‐life ethical dilemmas and are pressed to respond to these situations. Many possible treatments are being investigated, one of which is the use of hydroxychloroquine or chloroquine. These drugs are approved for use by patients with systemic lupus (...) erythematosus (SLE), rheumatoid arthritis, and malaria. The demand for these products has increased, and the stocks are depleting for the patient population for whom the drugs are intended initially. Although both innovator and generic pharmaceutical manufacturers are making plans for increased production, there are challenges with global supply chains disruption and the retention of supplies for local markets. This may cause countries that rely on the importation of pharmaceuticals to be out of stock of supplies for an extended period. There are allegations of off‐label prescribing and hoarding. Pharmacists are the custodians and dispensers of medications and are faced with the task of assessing prescriptions and making decisions about the allocation of these products. This paper seeks to 1) highlight some of the ethical challenges of dispensing hydroxychloroquine by pharmacists during the COVID‐19 pandemic, 2) identify some of the responses to these issues from various regulatory authorities in the USA, and 3) recommend approaches to assist pharmacists in their decision‐making process, especially in LMICs. (shrink)

Developing World Bioethics, Volume 21, Issue 4, Page 193-200, December 2021.

This qualitative study explored how 10 first-year peer educators understood and utilized their own socilal identities (e.g., their race, gender, sexual orientation, etc.) in their diversity education efforts. All participants saw their identities as having a profound impact on their teaching, although they identified many different, and sometimes contradictory influences. Their identities influenced their credibility as educators, use of emotion, and relationships with dominant and target group member students. Educators sometimes chose to discuss their own experiences with oppression and privilege, (...) and sometimes kept their identities hidden. Participants noted, in conclusion, the importance of considering the influence of their own identity, as awareness influenced how they approached their qork as diversity educators. (shrink)

This qualitative study explored how 10 first-year peer educators understood and utilized their own socilal identities (e.g., their race, gender, sexual orientation, etc.) in their diversity education efforts. All participants saw their identities as having a profound impact on their teaching, although they identified many different, and sometimes contradictory influences. Their identities influenced their credibility as educators, use of emotion, and relationships with dominant and target group member students. Educators sometimes chose to discuss their own experiences with oppression and privilege, (...) and sometimes kept their identities hidden. Participants noted, in conclusion, the importance of considering the influence of their own identity, as awareness influenced how they approached their qork as diversity educators. (shrink)

At Abhidharmakośa VI .3, Vasubandhu analyses the phrase sandhāya ... bha $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ ita $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{m} $$ as used in the sūtras. Here bhā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ ita $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{m} $$ mentions an utterance, to which a figurative sense is ascribed by the gerundive (not noun) sandhāya. The audience is split: some are intended to understand the literal, others the figurative sense. Vasubandhu's analysis works well for sandhābhā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ a etc. in the Saddharmapu $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{n}$$ $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{d}$$ arīka and the Guhyasamājatantra. (The Hevajratantra is (...) different and we consider it separately). Poussin's “arrière-pensée”, Edgerton's “real meaning” and “esoteric meaning”, and Wayman's “twilight language” are attractive in some cases but not all. Vasubandhu's analysis combined with Edgerton's “specially intended” (for ābhiprāyika) is much better; compare V. S. Bhattacharya's old paraphrase of this word “intended to imply or suggest something different from what is expressed by the words”. But Bhattacharya's widely accepted translation “intentional” for ābhiprāyika is misleading and misrepresents Vasubandhu, and we suggest ways of improving it in the light of the need for coherent translation, with the help of some considerations from Pā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{n}$$ ini and from Montague semantics. (shrink)

At Abhidharmakośa VI .3, Vasubandhu analyses the phrase sandhāya ... bha $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ ita $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{m} $$ as used in the sūtras. Here bhā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ ita $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{m} $$ mentions an utterance, to which a figurative sense is ascribed by the gerundive (not noun) sandhāya. The audience is split: some are intended to understand the literal, others the figurative sense. Vasubandhu's analysis works well for sandhābhā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{s} $$ a etc. in the Saddharmapu $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{n}$$ $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{d}$$ arīka and the Guhyasamājatantra. (The Hevajratantra is (...) different and we consider it separately). Poussin's “arrière-pensée”, Edgerton's “real meaning” and “esoteric meaning”, and Wayman's “twilight language” are attractive in some cases but not all. Vasubandhu's analysis combined with Edgerton's “specially intended” (for ābhiprāyika) is much better; compare V. S. Bhattacharya's old paraphrase of this word “intended to imply or suggest something different from what is expressed by the words”. But Bhattacharya's widely accepted translation “intentional” for ābhiprāyika is misleading and misrepresents Vasubandhu, and we suggest ways of improving it in the light of the need for coherent translation, with the help of some considerations from Pā $$\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle\cdot}$}}{n}$$ ini and from Montague semantics. (shrink)

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits—Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia —plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It (...) is the first comprehensive measure of the ICD-11 PD model in that it is the only one to include both PD dysfunction-severity as well as trait scales and because it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the “statistical” model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales’ psychometrics were excellent, as were the domains’ and their components’ convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed. (shrink)

The reproduction of cultural systems in cases where cultural group selection may occur is typically incomplete, with only certain cultural traits being adopted by less successful cultural groups. Why a particular trait and not another is transmitted might not be explained by cultural group selection. We explore this issue through the case of religious syncretism.