Despite an increase in international business ethics research in recent years, the number of studies focused on Latin America and China has been deficient. As trade among Pacific Rim nations increases, an understanding of the ethical beliefs of the people in this region of the world will become increasingly important. In the current study 208 respondents from Peru and China are queried about their ethical ideologies, firm practices, and commitment to organizational performance. The empirical results reveal that Chinese workers are (...) more relativistic and less idealistic than their Peruvian counterparts. One explanation for the disparity between these two groups is likely the variation in collectivism that can be traced to different levels of importance across ingroups and outgroups. In addition to a summary of the results, future research directions and managerial implications are discussed. (shrink)
As multinational firms explore new and promising national markets two of the most crucial elements in the strategic decision regarding market-entry are the level of corruption and existing trade barriers. One form of corruption that is crucially important to firms is the theft of intellectual property. In particular, software piracy has become a hotly debated topic due to the deep costs and vast levels of piracy around the world. The purpose of this paper is to assess how laissez-faire trade policies (...) and corruption affect national software piracy rates. Using invisible hand theory, as well as literature from the fields of international strategy and ethics, formal research hypotheses are posited and tested. Results suggest that corruption mediates the relationship between economic freedom and software piracy. Implications for multinational managers and researchers are also addressed. (shrink)
Despite an increase in international business ethics research in recent years, the number of studies focused on Latin America and China has been deficient. As trade among Pacific Rim nations increases, an understanding of the ethical beliefs of the people in this region of the world will become increasingly important. In the current study 208 respondents from Peru and China are queried about their ethical ideologies, firm practices, and commitment to organizational performance. The empirical results reveal that Chinese workers are (...) more relativistic and less idealistic than their Peruvian counterparts. One explanation for the disparity between these two groups is likely the variation in collectivism that can be traced to different levels of importance across ingroups and outgroups. In addition to a summary of the results, future research directions and managerial implications are discussed. (shrink)
With this issue, we begin a regular feature on bioethics and public health. We welcome Matthew K. Wynia, M.D., M.P.H., Director of the Institute for Ethics of the American Medical Association as our new Contributing Editor. If you have comments or suggestions regarding this feature, please email us at manuscript@ bioethics.net.
Up until fairly recently it was philosophical orthodoxy – at least within analytic aesthetics broadly construed – to hold that the appreciation and evaluation of works as art and moral considerations pertaining to them are conceptually distinct. However, following on from the idea that artistic value is broader than aesthetic value, the last 15 years has seen an explosion of interest in exploring possible inter-relations between the appreciative and ethical character of works as art. Consideration of these issues has a (...) distinguished philosophical history but as the Compass survey article suggests ('Art, Morality and Ethics: On the (Im)Moral Character of Art Works and Inter-Relations to Artistic Value.' Philosophy Compass 1.2 (2006): 129–43), it is only very recently that figures in the field have returned to it to develop more precisely what they take the relationships to be and why. Consensus is, unsurprisingly, lacking. The reinvigoration of the issues has led sophisticated formalists or autonomists to mount a more considered defence of the idea that aesthetic and literary values are indeed conceptually distinct from the justification or otherwise of the moral perspective or views endorsed in a work (Topic I). The challenges presented by such a defence are many but amongst them are appeals to critical practice (Lamarque and Olsen), scepticism about whether or not art really can give us bona fide knowledge (Stolnitz) and the recognition that truth often seems to be far removed from what it is we value in our appreciation of works (Lamarque). One way to motivate consideration of the relevance of a work's moral character to its artistic value concerns the phenomena of imaginative resistance. At least sometimes it would seem that, as Hume originally suggested, we either cannot or will not enter imaginatively into the perspective solicited by a work due to its morally problematic character (Topic II). In some cases, it would seem that as a matter of psychological fact, we cannot do so since it is impossible for us to imagine how it could be that a certain attitude or action is morally permissible or good (Walton). The question then is whether or not this is a function of morality in particular or constraints on imaginative possibility more generally and what else is involved. At other times, the phenomena seem to be driven by a moral reluctance to allow ourselves to enter into the dramatic perspective involved (Moran) or evaluation of the attitude expressed (Stokes). Nonetheless, it is far from obvious that this is so of all the attitudes or responses we judge to be morally problematic. After all, it looks like we can and indeed often do suspend or background particular cognitive and moral commitments in engaging with all sorts of works (Nichols and Weinberg). If the moral character of a work interacts with how we appreciate and evaluate them, then the pressing question is this: is there any systematic account of the relationship available to us? One way is to consider the relationship between our emotional responses to works and their moral character (Topic III). After all, art works often solicit various emotional responses from us to follow the work and make use of moral concepts in so doing (Carroll). Indeed, whether or not a work merits the sought for emotional responses often seems to be internally related to ethical considerations (Gaut). Yet, it is not obvious that we should apply our moral concepts or respond emotionally in our imaginative engagement with works as art as we should in real life (Kieran, Jacobson). A different route is via the thought that art can convey knowledge (Topic IV). There might be particular kinds of moral knowledge art distinctively suited to conveying (Nussbaum) or it may just be that art does so particularly effectively (Carroll, Gaut, Kieran). Either way where this can be tied to the artistic means and appreciation of a work it would seem that to cultivate moral understanding contributes to the value of a work and to betray misunderstanding is a defect. Without denying the relevance of the moral character of a work some authors have wanted to claim that sometimes the immoral aspect of a work can contribute to rather than lessen its artistic value (Topic V). One route is to claim that there is no systematic theoretical account of the relationship available and what the right thing to say is depends on the particular case involved (Jacobson). Another involves the claim that this is so when the defect connects up in an appropriate way to one of the values of art. Thus, it has been claimed, only where a work reveals something which adds to intelligibility, knowledge or understanding in virtue of its morally problematic aspect can this be so (Kieran). The latter position looks like it could in principle be held whilst nonetheless maintaining that the typical or standard relationship is as the moralists would have it. Yet perhaps allowing valence change for such reasons is less a mark of principled explanation and more a function of downright inconsistency or incoherence (Harold). The topics themselves and suggested readings given below follow the structure articulated above as further amplified in the Compass survey article. The design and structure given below can be easily compressed or expanded further. Author Recommends 1. Carroll, Noël. 'Art, Narrative and Moral Understanding.' Aesthetics and Ethics: Essay at the Intersection . Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 126–60. This article develops the idea that engaging with narrative art calls on moral concepts and emotions and can thereby clarify our moral understanding. 2. Carroll, Noël. Beyond Aesthetics: Philosophical Essays . Cambridge: Cambridge UP, 2009. Part IV consists of six distinct essays on questions concerning the inter-relations between art and morality including the essay cited above and the author's articulation and defence of moderate moralism. 3. Gaut, Berys. 'The Ethical Criticism of Art.' Aesthetics and Ethics: Essay at the Intersection . Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 182–203. 4. Gaut, Berys. Art, Emotion and Ethics . Oxford: Oxford UP, 2007. This monograph provides the most exhaustive treatment of the issues and defends the claim that, where relevant, whenever a work is morally flawed it is of lesser value as art and wherever it is morally virtuous the work's value as art is enhanced. Chapters 7 and 8 defend concern ethical knowledge and chapter 10 is a development of the article cited above concerning emotional responses. Chapter 3 also gives a useful conceptual map of the issues and options in the debate. 5. Jacobson, Daniel. 'In Praise of Immoral Art.' Philosophical Topics 25 (1997): 155–99. A wide ranging and extended treatment of relevant issues which objects to generalising moral treatments of our responses to art works and defends the idea that particular works can be better because of rather than despite their moral defects. 6. Kieran, Matthew. 'Forbidden Knowledge: The Challenge of Cognitive Immoralism.' Art and Morality . Ed. Sebastian Gardner and José Luis Bermúdez. London: Routledge, 2003. 56–73. A general argument for immoralism is elaborated by outlining when, where and why a work's morally problematic character can contribute to its artistic value for principled reasons (through enhancing moral understanding). 7. Kieran, Matthew. Revealing Art . London: Routledge, 2005. Chapter 4. This chapter argues against both aestheticism and straightforward moralism about art, elaborating a defence of immoralism in relation to visual art whilst ranging over issues from pornographic art to the nature and demands of different genres in art. 8. Lamarque, Peter. 'Cognitive Values in the Arts: Marking the Boundaries.' Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006, 127–39. This article concisely outlines and defends a sophisticated aestheticism that denies the importance of truth to artistic value. 9. Stolnitz, Jerome. 'On the Cognitive Triviality of Art.' British Journal of Aesthetics 32.3 (1992): 191–200. This article articulates and defends the claim that no knowledge of any interesting or significant kind can be afforded by works appreciated and evaluated as art. 10. Walton, Kendall. 'Morals in Fiction and Fictional Morality, I.' Proceedings of the Aristotelian Society, Suppl. 68 (1994): 27–51. This article builds on some comments from Hume to develop the idea that when engaging with fictions it seems impossible imaginatively to enter into radically deviant moral attitudes. Online Materials 'Aesthetics and Ethics: The State of the Art.' American Society of Aesthetics online (Jeffrey Dean): http://www.aesthetics-online.org/articles/index.php?articles_id=15 >. 'Art, Censorship and Morality' downloadable podcast of Nigel Warburton interviewing Matthew Kieran at Tate Britain (BBC/OU Open2.net as part of the Ethics Bites series): http://www.open2.net/ethicsbites/art-censorship-morality.html >. 'Art, Morality and Ethics: On the (Im)Moral Character of Art Works and Inter-Relations to Artistic Value.' Philosophy Compass 1.2 (2006): 129–43 (Matthew Kieran): http://www3.interscience.wiley.com/journal/118557779/abstract >. 'Ethical Criticism of Art.' Internet Encyclopedia of Philosophy (Ella Peek): http://www.iep.utm.edu/a/art-eth.htm >. 'Fascinating Fascism.' New York Review of Books Piece Discussing Leni Riefenstahl (Susan Sontag): http://www.nybooks.com/articles/9280 >. 'The Beheading of St. John the Baptist (1450s), Giovanni de Paolo' (Tom Lubbock): http://www.independent.co.uk/arts-entertainment/art/great-works/great-works-the-beheading-of-st-john-the-baptist-1450s-giovanni-di-paolo-1684900.html >. Vladimir Nabokov and Lionel Trilling discuss Lolita (CBS): http://www.listal.com/video/3848698 >. Sample Syllabus Topic I Autonomism/Aestheticism • Anderson, James C. and Jeffrey T. Dean. 'Moderate Autonomism.' British Journal of Aesthetics 38.2 (1998): 150–66. • Beardsley, Monroe. Aesthetics: Problems in the Philosophy of Criticism . New York: Harcourt, Brace and World, 1958. Chapter 12. • Kant, Immanuel. The Critique of Judgement.Trans. James Creed Meredith . Oxford: Oxford UP, 1952 [1790]. • Lamarque, Peter. 'Cognitive Values in the Arts: Marking the Boundaries.' Contemporary Debates in Aesthetics and the Philosophy of Art . Ed. Matthew Kieran. Oxford: Blackwell, 2006, 127–39. • ——. 'Tragedy and Moral Value.' Australasian Journal of Philosophy 73.2 (1995): 239–49. • Lamarque, Peter and Stein Olsen. Truth, Fiction and Literature . Oxford: Clarendon Press, 1994. Chapter 10. • Stolnitz, Jerome. 'On the Cognitive Triviality of Art.' British Journal of Aesthetics 32.3 (1992): 191–200. Topic II Imaginative Capacities, Intelligibility and Resistance • Moran, Richard. 'The Expression of Feeling in Imagination.' Philosophical Review 103.1 (1994): 75–106. • Nichols, Shaun. 'Just the Imagination: Why Imagining Doesn't Behave Like Believing'. Mind & Language 21.4 (2006): 459–74. • Stokes, Dustin. 'The Evaluative Character of Imaginative Resistance'. British Journal of Aesthetics 46.4 (2006): 387–405. • Tanner, Michael. 'Morals in Fiction and Fictional Morality, II'. Proceedings of the Aristotelian Society, Suppl. Vol. 68 (1994): 51–66. • Walton, Kendall (1994). 'Morals in Fiction and Fictional Morality, I'. Proceedings of the Aristotelian Society, Suppl. Vol. 68 (1994): 27–51. • Weinberg, Jonathan. 'Configuring the Cognitive Imagination.' New Waves in Aesthetics . Eds. K. Stock and K. Thomson-Jones. London: Palgrave Macmillan, 2008. 203–23. Topic III Moralism and Emotions • Carroll, Noël. 'Moderate Moralism.' British Journal of Aesthetics 36.3 (1996): 223–37. • Carroll, Noël. 'Art, Narrative and Moral Understanding.' Aesthetics and Ethics: Essay at the Intersection . Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998.126–60. • Gaut, Berys. Art, Emotion and Ethics . Oxford: Oxford UP, 2007. Chapter 10. • ——. 'The Ethical Criticism of Art.' Aesthetics and Ethics: Essay at the Intersection . Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 182–203. • Hume, David. 'Of the Standard of Taste.' Selected Essays . Oxford: Oxford UP, 1993 [1757]. 133–53. • Kieran, Matthew. 'Emotions, Art and Immorality.' Oxford Handbook to the Philosophy of Emotions . Ed. Peter Goldie. Oxford: Oxford UP, 2009. 681–703. • Tolstoy, Leo. What is Art? . London: Penguin, 2004. Chapters 5 and 15. Topic IV Moralism and Knowledge • Aristotle. Poetics . Trans. M. Heath. London: Penguin, 1996 [367–322 BC]. • Carroll, Noël. 'The Wheel of Virtue: Art, Literature and Moral Knowledge.' Journal of Aesthetics and Art Criticism 60.1 (2002): 3–26. • Gaut, Berys. Art, Emotion and Ethics . Oxford: Oxford UP, 2007. Chapters 7 and 8. • Gaut, Berys. 'Art and Cognition.' Contemporary Debates in Aesthetics and the Philosophy of Art . Ed. Matthew Kieran. Oxford: Blackwell, 2006. 115–26. • Kieran, Matthew. 'Art, Imagination and the Cultivation of Morals.' Journal of Aesthetics and Art Criticism 54.4 (1996): 337–51. • Nussbaum, Martha. 'Finely Aware and Richly Responsible: Literature and the Moral Imagination.' Love's Knowledge . New York: Oxford UP, 1990. 148–68. • Plato. The Republic . Trans. D. Lee. Harmondsworth: Penguin, 1974. Book 10. Topic V Immoralist Contextualism • Harold, James. 'Immoralism and the Valence Constraint.' British Journal of Aesthetics 48.1 (2008): 45–64. • Jacobson, Daniel. 'In Praise of Immoral Art.' Philosophical Topics 25 (1997): 155–99. • ——. 'Ethical Criticism and the Vices of Moderation.' Contemporary Debates in Aesthetics and the Philosophy of Art . Ed. Matthew Kieran. Oxford: Blackwell, 2006. 342–55. • John, Eileen. 'Artistic Value and Moral Opportunism.' Contemporary Debates in Aesthetics and the Philosophy of Art . Ed. Matthew Kieran. Oxford: Blackwell, 2006. 331–41. • Kieran, Matthew. 'Forbidden Knowledge:The Challenge of Cognitive Immoralism.' Art and Morality . Ed. Sebastian Gardner and José Luis Bermúdez. London: Routledge, 2003. 56–73. • Kieran, Matthew. Revealing Art . London: Routledge, 2005. Chapter 4. • Patridge, Stephanie. 'Moral Vices as Artistic Virtues: Eugene Onegin and Alice.' Philosophia 36.2 (2008): 181–93. Focus Questions 1. What is the strongest argument for the claim that the moral character of a work is not relevant to its artistic value? Does artistic or literary criticism tend to concern itself with the truth or morality of works? If so, in what ways? If not, why do you think this is? 2. What different explanations might there be for difficulty with or resistance to imaginatively entering into attitudes you take to be immoral? How might this relate to the way our imaginings work as contrasted with belief? How might different literary or artistic treatments of the same subject matter make a difference? 3. How do narrative works draw on our moral concepts and responses? Can we suspend our normal moral commitments or application of moral concepts in responding emotionally to art works? Should we respond emotionally to art works as we ought to respond to real world events we witness? Why? Why not? 4. How, if at all, do art works convey moral understanding? How, if at all, is this related to the kinds of moral knowledge art works can teach or reveal to us? When, where and why might this be tied to the artistic value of a work? How can we tell where a work enhances our moral understanding as opposed to misleading or distorting it? 5. What art works do you value overall as art which commend or endorse moral values and attitudes that you do not? Is appreciation of them always marred or lessened by the morally dubious aspect? If not, what explains the differences in evaluation? What, if anything, might you learn by engaging with works which endorse moral attitudes or apply moral concepts different from those you take to be justified? How, if at all, might this connect up with what makes them valuable as art? (shrink)
This is the first book to explore the cognitive science of effortless attention and action. Attention and action are generally understood to require effort, and the expectation is that under normal circumstances effort increases to meet rising demand. Sometimes, however, attention and action seem to flow effortlessly despite high demand. Effortless attention and action have been documented across a range of normal activities--from rock climbing to chess playing--and yet fundamental questions about the cognitive science of effortlessness have gone largely unasked. (...) -/- This book draws from the disciplines of cognitive psychology, neurophysiology, behavioral psychology, genetics, philosophy, and cross-cultural studies. Starting from the premise that the phenomena of effortless attention and action provide an opportunity to test current models of attention and action, leading researchers from around the world examine topics including effort as a cognitive resource, the role of effort in decision making, the neurophysiology of effortless attention and action, the role of automaticity in effortless action, expert performance in effortless action, and the neurophysiology and benefits of attentional training. -/- Contributors: Joshua M. Ackerman, James H. Austin, John A. Bargh, Roy F. Baumeister, Sian L. Beilock, Chris Blais, Matthew M. Botvinick, Brian Bruya, Mihaly Csikszentmihalyi, Marci S. DeCaro, Arne Dietrich, Yuri Dormashev, László Harmat, Bernhard Hommel, Rebecca Lewthwaite, Örjan de Manzano, Joseph T. McGuire, Brian P. Meier, Arlen C. Moller, Jeanne Nakamura, Evgeny N. Osin, Michael I. Posner, Mary K. Rothbart, M. R. Rueda, Brandon J. Schmeichel, Edward Slingerland, Oliver Stoll, Yiyuan Tang, Töres Theorell, Fredrik Ullén, Robert D. Wall, Gabriele Wulf. (shrink)
There are three broad ethical issues related to handling public health emergencies. They are the three R's - rationing, restrictions and responsibilities. Recently, a severe shortage of annual influenza vaccine in the US, combined with the threat of pandemic flu, has provided an opportunity for policy makers to think about rationing in very concrete terms. Some lessons from annual flu vaccination likely will apply to pandemic vaccine distribution, but many preparatory decisions must be based on very rough estimates. What ethical (...) principles should guide rationing decisions, what data should inform these decisions, how to revise decisions as new data emerge, and how to implement rationing decisions on the ground are all important considerations. In addition, ethicists might be able to help policy makers think through the importance of international cooperation in surmounting global rationing dilemmas and to accept the inevitable responsibilities of government in making and implementing rationing decisions. (shrink)
Recent arguments over whether certain public health interventions should be mandatory raise questions about what counts as a "mandate." A mandate is not the same as a mere recommendation or the standard of practice. At minimum, a mandate should require an active opt-out and there should be some penalty for refusing to abide by it. Over-loose use of the term "mandate" and the easing of opt-out provisions could eventually pose a risk to the gains that truly mandatory public health interventions, (...) such as childhood vaccines, have provided over the last 50 years. Already, confusion about what counts as a mandate, and about what criteria should be used to determine when a public health intervention should be implemented as a mandate, has led to some inappropriate public policy decisions. For instance, by any reasonable criteria, the yearly influenza vaccine should be mandatory for health care workers. To enforce this mandate, those who refuse vaccination should be required to sign a waiver, and patients - especially those at high risk from flu - should be informed when they receive care from unvaccinated practitioners. (shrink)
Confidentiality is a core value in medicine and public health yet, like other core values, it is not absolute. Medical ethics has typically allowed for breaches of confidentiality when there is a credible threat of significant harm to an identifiable third party. Medical ethics has been less explicit in spelling out criteria for allowing breaches of confidentiality to protect populations, instead tending to defer these decisions to the law. But recently, issues in military detention settings have raised the profile of (...) decisions to breach medical confidentiality in efforts to protect the broader population. National and international ethics documents say little about the confidentiality of detainee medical records. But initial decisions to use detainee medical records to help craft coercive interrogations led to widespread condemnation, and might have contributed to detainee health problems, such as a large number of suicide attempts several of which have been successful. More recent military guidance seems to reflect lessons learned from these problems and does more to protect detainee records. For the public health system, this experience is a reminder of the importance of confidentiality in creating trustworthy, and effective, means to protect the public's health. (shrink)
The three primary ethical challenges in preparing for public health emergencies - addressing questions of rationing, restrictions and responsibilities - all entail confronting uncertainty. But the third, considering whether people and institutions will live up to their responsibilities in a crisis, is perhaps the hardest to predict and therefore plan for. The quintessential example of a responsibility during a public health emergency is that of health care professionals' obligation to continue caring for patients during epidemics. Historically, this 'duty to treat' (...) has sometimes gone unrecognized or ignored, but it has also famously been adhered to, including during the recent SARS epidemic. And non-crisis examples of health professionals working in the face of personal risk are very common. The duty to treat should be circumscribed by several considerations, including the levels or risk and benefit at issue, the degree of public reliance on health professional action, and the nature of the individual health professional's acceptance of greater than usual risk. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors' responsibilities. Public health ethics as well as professional ethics can help frame answers to some key questions: How strong are ethical responsibilities during crises? To whom do they apply? Should they be more explicit - and hence more circumscribed - or less explicit and hence largely aspirational? And how can public health policies encourage responsible actions? (shrink)
The Centers for Disease Control and Prevention (CDC) recently recommended that HIV screening should become routine for all adults in the United States. Implicit in the CDC proposal is the notion that pre-test counseling would be more limited than at present, and that written informed consent to screening would no longer be required. If widely implemented, routine testing would mark a tremendous shift in the US HIV screening strategy. There are a number of considerations used to determine what screening tests (...) should be routine, and HIV fits the bill in almost every regard. Yet the stigma associated with HIV infection remains, making the CDC's recommendation highly controversial. Will minimizing requirements for pre-test counseling and special written informed consent lead to unexpected or unwanted HIV testing, or do these stringent counseling and consent requirements needlessly scare people away? Will widespread and routine testing be associated with declining stigmatization, or will it drive some patients away from seeking desperately needed health care? These are high stakes questions, and we're about to find out the answers. (shrink)
Responses to public health emergencies can entail difficult decisions about restricting individual liberties to prevent the spread of disease. The quintessential example is quarantine. While isolating sick patients tends not to provoke much concern, quarantine of healthy people who only might be infected often is controversial. In fact, as the experience with severe acute respiratory syndrome (SARS) shows, the vast majority of those placed under quarantine typically don't become ill. Efforts to enforce involuntary quarantine through military or police powers also (...) can backfire, stoking both panic and disease spread. Yet quarantine is part of a limited arsenal of options when effective treatment or prophylaxis is not available, and some evidence suggests it can be effective, especially when it is voluntary, home-based and accompanied by extensive outreach, communication and education efforts. Even assuming that quarantine is medically effective, however, it still must be ethically justified because it creates harms for many of those affected. Moreover, ethical principles of reciprocity, transparency, non-discrimination and accountability should guide any implementation of quarantine. (shrink)
This article helps to clarify and articulate the ideological, legal, and ethical attitudes regarding software as intellectual property (IP). Computer software can be viewed as IP from both ethical and legal perspectives. The size and growth of the software industry suggest that large profits are possible through the development and sale of software. The rapid growth of the open source movement, fueled by the development of the Linux operating system, suggests another model is possible. The large number of unauthorized copies (...) of software programs suggests that many people do not believe in laws regarding software copyright. There are many and varied views of software as IP, even within the information systems (IS) profession. In this article, four distinct subgroups of IS professionals are identified. The article describes the four subgroups and their respective ideological views on software ownership; it explores the subgroups' attitudes regarding software laws; and finally, it explains the ethical positions embraced by each subgroup. (shrink)
Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got (...) in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust. (shrink)
The CDC's HIV screening recommendations for health care settings advocate abandoning two important autonomy protections: (1) pretest counseling and (2) the requirement that providers obtain affirmative agreement from patients prior to testing. The recommendations may violate the least infringement principle because there is insufficient evidence to conclude that abandoning pretest counseling or affirmative agreement requirements will further the CDC's stated public health goals.
* Disclaimer: The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.
The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public (...) came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism. (shrink)
We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving (...) informed consent-in both face-to-face and online experiments. (shrink)
Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)
Most direct reference theorists about indexicals and proper names have adopted the thesis that singular propositions about physical objects are composed of physical objects and properties (and/or relations—I will use "properties" for brevity's sake).1 There have been a number of recent proponents of such a view, including Scott Soames, Nathan Salmon, John Perry, Howard Wettstein, and David Kaplan.2 Since Kaplan is the individual who (at least recently) is best known for holding such a view, let's call a proposition that (...) is composed of objects and properties a K-proposition. In this paper, I will attempt to show that (given some fairly plausible assumptions) a direct reference view about the content of proper names and indexicals leads very naturally to the position that all singular propositions about physical objects are K-propositions.3 Then, I will attempt to show that this view of propositions is false. I will spend the bulk of the paper on this latter task. My goal in the paper, then, is to show that adopting the direct reference thesis comes at a cost (or for those who thought it already came at a cost because of (alleged) problems the view has with problems such as opacity and the significance of some identity statements; it comes at even more of a cost). (shrink)
There is no uniquely standard concept of an effectively decidable set of real numbers or real n-tuples. Here we consider three notions: decidability up to measure zero [M.W. Parker, Undecidability in Rn: Riddled basins, the KAM tori, and the stability of the solar system, Phil. Sci. 70(2) (2003) 359–382], which we abbreviate d.m.z.; recursive approximability [or r.a.; K.-I. Ko, Complexity Theory of Real Functions, Birkhäuser, Boston, 1991]; and decidability ignoring boundaries [d.i.b.; W.C. Myrvold, The decision problem for entanglement, in: R.S. (...) Cohen et al. (Eds.), Potentiality, Entanglement, and Passion-at-a-Distance: Quantum Mechanical Studies fo Abner Shimony, Vol. 2, Kluwer Academic Publishers, Great Britain, 1997, pp. 177–190]. Unlike some others in the literature, these notions apply not only to certain nice sets, but to general sets in Rn and other appropriate spaces. We consider some motivations for these concepts and the logical relations between them. It has been argued that d.m.z. is especially appropriate for physical applications, and on Rn with the standard measure, it is strictly stronger than r.a. [M.W. Parker, Undecidability in Rn: Riddled basins, the KAM tori, and the stability of the solar system, Phil. Sci. 70(2) (2003) 359–382]. Here we show that this is the only implication that holds among our three decidabilities in that setting. Under arbitrary measures, even this implication fails. Yet for intervals of non-zero length, and more generally, convex sets of non-zero measure, the three concepts are equivalent. (shrink)
Matthew Walker's article has prompted us to consider neuropsychiatric disorders and pharmacological effects associated with sleep alterations, and aspects of memory affected. Not all disorders involving insomnia show memory impairment, and hypersomnias can be associated with memory deficits. The use of cholinergic medication in dementia indicates that consideration of the link between sleep and memory is more than academic.
In previous work we gave an approach, based on labelled natural deduction, for formalizing proof systems for a large class of propositional modal logics that includes K, D, T, B, S4, S4.2, KD45, and S5. Here we extend this approach to quantified modal logics, providing formalizations for logics with varying, increasing, decreasing, or constant domains. The result is modular with respect to both properties of the accessibility relation in the Kripke frame and the way domains of individuals change between worlds. (...) Our approach has a modular metatheory too; soundness, completeness and normalization are proved uniformly for every logic in our class. Finally, our work leads to a simple implementation of a modal logic theorem prover in a standard logical framework. (shrink)
