Some authors argue that it is permissible for clinicians to conscientiously provide abortion services because clinicians are already allowed to conscientiously refuse to provide certain services. Call this the symmetry thesis. We argue that on either of the two main understandings of the aim of the medical profession—what we will call “pathocentric” and “interest‐centric” views—conscientious refusal and conscientious provision are mutually exclusive. On pathocentric views, refusing to provide a service that takes away from a patient's health is professionally justified (...) because there are compelling reasons, based on professional standards, to refuse to provide that service (e.g., it does not heal, and it is contrary to the goals of medicine). However, providing that same service is not professionally justified when providing that service would be contrary to the goals of medicine. Likewise, the thesis turns out false on interest‐centric views. Refusing to provide a service is not professionally justified when that service helps the patient fulfill her autonomous preferences because there are compelling reasons, based on professional standards, to provide that service (e.g., it helps her achieve her autonomous preferences, and it would be contrary to the goals of medicine to deny her that service). However, refusing to provide that same service is not professionally justified when refusing to provide that service would be contrary to the goals of medicine. As a result, on either of the two most plausible views on the goals of medicine, the symmetry thesis turns out false. (shrink)

The long-standing overarching policy governing research with human subjects conducted and supported by most federal agencies and departments in the United States, known as the Common Rule, has recently been revised, with most requirements slated to become effective in 2018. Although there are multiple alterations to the current regulations, some of the most significant changes aim to enhance consent for research. While some of the particular provisions in this regard will be easy to apply and promise to help meet this (...) goal, others may be more challenging to implement despite their intuitive appeal. In this article, I examine some of the provisions in the revised Common Rule that relate to consent: new required consent elements; the goal of comprehension in the consent process; consent forms; and broad consent. By raising issues about these provisions now and suggesting possible ways to overcome their potential shortfalls, the hope is that future efforts can be taken to help clarify and appropriately implement them. (shrink)

A community faces the obligation of providing an indivisible public good that each of its members is able to provide at a certain cost. The solution is to rely on the member who can provide the public good at the lowest cost, with a due compensation from the other members. This problem has been studied in a non-cooperative setting by Kleindorfer and Sertel. They propose an auction mechanism that results in an interval of possible individual contributions whose lower bound is (...) the equal division. Here, instead we take a cooperative stand point by modelling this problem as a cost sharing game that turns out to be a ‘reverse’ airport game whose core is shown to have a regular structure. This enables an easy calculation of the nucleolus that happens to define the upper bound of the Kleindorfer–Sertel interval. The Shapley value instead is not an appropriate solution in this context because it may imply compensations to non-providers. (shrink)

If we hope to see values of equality and democracy embodied in our societies’ institutions, then we have a range of good reasons to favor expansive public provision of goods and services, and to oppose many forms of privatization. While Joseph Heath is right to argue that there are at least some forms of ‘anodyne privatization’, and while he is also right to argue for a more nuanced philosophical debate about the different dimensions of choice between forms of public (...) and private provision, Heath fails to register various regards in which private provision can undermine these central public values. We often have strong egalitarian and democratic reasons to protect zones of decommodification; to resist the imposition of user-charges; and to favor insourcing and direct public procurement over various forms of outsourcing of public services. Public libraries provide a totemic illustration of some of the deep virtues of collective public provision in democratic societies. Overall, our reasons to reject privatization are stronger and more diverse than theorists such as Heath might have supposed. (shrink)

Food provisioning refers to the mental, physical and emotional labor involved in providing food for oneself and one’s family. The labor of food provisioning has been found to be made more difficult by a number of factors, including gender, socioeconomic status, age, and geography. However, little research has been done examining the labor of food provisioning among farm workers, a significantly marginalized population in the United States. In order to examine the food provisioning strategies and struggles of farm workers, we (...) have been conducting pilot research with Latinx agricultural workers in southwestern Idaho. Employing a range of qualitative and quantitative methods, we examine the various strategies that farm workers use to provide food for themselves and their families, including accessing food banks, utilizing food stamps, purchasing groceries and accepting food from friends, family and employers. We consider this from a wider lens of “caring labor”. In addition, we explore food provisioning strategies in the context of economic and demographic changes in Idaho. We observe the ways in which changing crop patterns, in particular the growth the hops industry, relates to a transition in the labor force, especially an increase in women farm workers. We have also observed a shift away from employing migrant farm labor and towards the employment of “settled” Latinx residents from surrounding communities. These changes all influence the labor of food provisioning for rural Idaho Latinx families. (shrink)

Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not affect their (...) access to medical treatments that significantly prolong life, relieve suffering, or cure or mitigate disabilities. Government should ensure this even if doing so involves leveling down and even if it is unclear whether egalitarian provision of necessary treatment would provide better care to the poor than a less egalitarian health care system would. (shrink)

Despite its effectiveness, limited research has examined the provision of telemental health and how practices may vary according to treatment paradigm. We surveyed 276 community mental health providers registered with a commercial telemedicine platform. Most providers reported primarily offering TMH services to adults with anxiety, depression, and trauma-and stressor-related disorders in individual therapy formats. Approximately 82% of TMH providers reported endorsing the use of Cognitive Behavioral Therapy in their remote practice. The most commonly used in-session and between-session exercises included (...) coping and emotion regulation, problem solving, mindfulness, interpersonal skills, relaxation, and modifying and addressing core beliefs. CBT TMH providers had a higher odds of using in-session and homework exercises and assigning them through postal mail, email or fax methods, as compared to non-CBT TMH providers. TMH providers, regardless of treatment paradigm, felt that assigning homework was neither easy nor difficult and they believed their patients were somewhat-to-moderately compliant to their assigned exercises. CBT TMH providers also collected clinical information from their patients more often than non-CBT TMH providers. They reported being less satisfied with their method, which was identified most often as paper-based surveys and forms. Overall, TMH providers employ evidence-based treatments to their patients remotely, with CBT TMH providers most likely to do so. Findings highlight the need for innovative solutions to improve how TMH providers that endorse following the CBT treatment paradigm remotely assign homework and collect clinical data to increase their satisfaction via telemedicine. (shrink)

In some jobs, the correlation between effort and output is almost zero. For instance, money managers are primarily paid for luck. Using a controlled lab experiment, we examined under which conditions workers are willing to put in effort even if the output is determined by pure luck. We varied whether the employer could observe the workers’ effort, as well as whether the employer knows that earnings were determined by luck. We find that, workers believed that the employer will reward their (...) effort even if their effort does not affect earnings. Consequently, workers work harder if the employer could observe their effort. Moreover, even when the employer only saw earnings and not effort, workers labored harder if the employer did not know that earnings were determined by luck. (shrink)

We use data collected among Hadza hunter-gatherers between 2005 and 2009 to examine hypotheses about the causes and consequences of men’s foraging and food sharing. We find that Hadza men foraged for a range of food types, including fruit, honey, small animals, and large game. Large game were shared not like common goods, but in ways that significantly advantaged producers’ households. Food sharing and consumption data show that men channeled the foods they produced to their wives, children, and their consanguineal (...) and affinal kin living in other households. On average, single men brought food to camp on 28% of days, married men without children at home on 31% of days, and married men with children at home on 42% of days. Married men brought fruit, the least widely shared resource, to camp significantly more often than single men. A model of the relationship between hunting success and household food consumption indicates that the best hunters provided 3–4 times the amount of food to their families than median or poor hunters. These new data fill important gaps in our knowledge of the subsistence economy of the Hadza and uphold predictions derived from the household and kin provisioning hypotheses. Key evidence and assumptions backing prior claims that Hadza hunting is largely a form of status competition were not replicated in our study. In light of this, family provisioning is a more viable explanation for why good hunters are preferred as husbands and have higher fertility than others. (shrink)

Although previous work has linked parent autonomy support to the development of children’s executive function skills, the role of specific autonomy-supportive behaviors has not been thoroughly investigated. We compiled data from four preschool-age samples in the Midwestern United States to examine three relevant autonomy-supportive behaviors and their associations with child EF. We coded parent autonomy-supportive behaviors from a 10-min interaction between parent and child dyads working on challenging jigsaw puzzles together. Children completed a battery of EF. Overall, child EF was (...) most consistently correlated with the offering choice subscale. Additionally, only the offering choice subscale predicted child EF while controlling for the other autonomy support subscales and child age. These results suggest that parent provision of choice is an especially relevant aspect of autonomy-supportive parenting and may be important to the development of EF in early childhood. Future research should directly measure children’s experience with choice and how it relates to emerging EF. (shrink)

Legislation usually lacks a systematic organization which makes the management and the access to norms a hard problem to face. A more analytic semantic unit of reference (provision) for legislative texts was identified. A model of provisions (provisions types and their arguments) allows to describe the semantics of rules in legislative texts. It can be used to develop advanced semantic-based applications and services on legislation. In this paper an automatic bottom-up strategy to qualify existing legislative texts in terms of (...) provision types is described. (shrink)

This article seeks to identify and analyse the most significant changes regarding parental leave provision in post-communist Romania, as well as the extent to which its legal adjustments that took place after 1990 reveal both old trends inherited from the former political regime as well as new tendencies influenced by EU norms and directives. Consequently, this article has a twofold structure. First, a brief overview of the main concepts and theoretical approaches to parental leave will allow us to proceed (...) to a proper understanding of the epistemological tools underpinning this research object. Second, this article tackles the numerous legislative changes concerning parental leave that occurred after the fall of the communist regime. Although limited to a single category of research sources, this inquiry is indispensable for analysing the extent to which childcare and the gendered division of parental responsibilities have become real political struggles within the post-communist public agenda in Romania. (shrink)

Vincent Descombes brings together an astonishingly large body of philosophical and anthropological thought to present a thoroughgoing critique of contemporary cognitivism and to develop a powerful new philosophy of the mind. Beginning with a critical examination of American cognitivism and French structuralism, Descombes launches a more general critique of all philosophies that view the mind in strictly causal terms and suppose that the brain--and not the person--thinks. Providing a broad historical perspective, Descombes draws surprising links between cognitivism and earlier anthropological (...) projects, such as Lévi-Strauss's work on the symbolic status of myths. He identifies as incoherent both the belief that mental states are detached from the world and the idea that states of mind are brain states; these assumptions beg the question of the relation between mind and brain. In place of cognitivism, Descombes offers an anthropologically based theory of mind that emphasizes the mind's collective nature. Drawing on Wittgenstein, he maintains that mental acts are properly attributed to the person, not the brain, and that states of mind, far from being detached from the world, require a historical and cultural context for their very intelligibility. Available in English for the first time, this is the most outstanding work of one of France's finest contemporary philosophers. It provides a much-needed link between the continental and Anglo-American traditions, and its impact will extend beyond philosophy to anthropology, psychology, critical theory, and French studies. (shrink)

The need for continuing provision of beneficial experimental interventions after research is concluded remains a controversial topic in bioethics for research. Based on the principle of beneficence, justice as reciprocity, concerns about exploitation and fair benefits, participants should be able to have continuing access to benefits beyond the research period. However, there is no consensus about whether or not post-trial provision of beneficial interventions should be mandatory for participants from developing countries. This paper summarises recommendations from international and (...) national guidelines. Ethical principles and practical issues relating to post-trial provision are also discussed. In conclusion, post-trial provision is not necessary in all situations and a set of criteria are proposed to identify the situations that beneficial interventions should be provided beyond the research period. However, mandatory post-trial supply of beneficial experimental interventions should be assured for those who still need and are able to benefit from them but have no alternative access. Mandatory provision is based on universal bioethical principles such as beneficence and justice. Furthermore, difficulties associated with implementation of post-trial provision are not unmanageable. Careful advanced planning and a comprehensive partnership among relevant parties would be very helpful in solving these difficulties in practice, which therefore should not be taken as an excuse to escape post-trial responsibility. (shrink)

Epistemic relationism in the theory of assertion is the view that an assertion's epistemic propriety depends purely on the relation between the asserter and the proposition asserted. Many accounts of assertion are relationist in this sense, including the familiar knowledge, belief, and justification accounts. A notable feature of such accounts is that they give no direct importance to the role of hearer: as far as such accounts are concerned, we need make no mention of hearers in characterising an assertion's propriety (...) conditions. This paper develops an account which rejects relationism, by giving central importance to the role of hearer. The paper introduces the knowledge provision account, according to which an assertion that p is proper only if it is fit to give a hearer knowledge that p. The paper aims to show: (i) that we can understand this account in a way which does not leave it open to obvious counterexamples, (ii) that it does not reduce to any familiar relationist account, and (iii) that it carries certain advantages over familiar relationist accounts. (shrink)

Background: This article describes the types of community‐wide benefits provided by investigators conducting public health research in South Asia as well as their self‐reported reasons for providing such benefits.Methods: We conducted 52 in‐depth interviews to explore how public health investigators in low‐resource settings make decisions about the delivery of ancillary care to research subjects. In 39 of the interviews respondents described providing benefits to members of the community in which they conducted their study. We returned to our narrative dataset to (...) find answers to two questions: What types of community‐wide benefits do researchers provide when conducting public health intervention studies in the community setting, and what reasons do researchers give when asked why they provided community‐wide benefits?Findings: The types of community‐wide benefits delivered were directed to the health and well‐being of the population. The most common types of benefits delivered were the facilitation of access to health care for individuals in acute medical need and emergency response to natural disasters. Respondents' self‐reported reasons when asked why they provided such benefits fell into 2 general categories: intrinsic importance and instrumental importance. (shrink)

Providing effective feedback to patients in a rehabilitation training program is essential. As technologies are being developed to support patient training, they need to be able to provide the users with feedback on their performance. As there are various aspects on which feedback can be given, it is important to ensure that users are not overwhelmed by too much information given too frequently by the assistive technology. We created a rule-based set of guidelines for the desired hierarchy, timing, and content (...) of feedback to be used when stroke patients train with an upper-limb exercise platform which we developed. The feedback applies to both success on task completion and to the execution of compensatory movements, and is based on input collected from clinicians in a previous study. We recruited 11 stroke patients 1–72 months from injury onset. Ten participants completed the training; each trained with the rehabilitation platform in two configurations: with motor feedback and with no motor feedback. The two conditions were identical, except for the feedback content provided: in both conditions they received feedback on task success; in the MF condition they also received feedback on making undesired compensatory movements during the task. Participants preferred the configuration that provided feedback on both task success and quality of movement. This pilot experiment demonstrates the feasibility of a system providing both task-success and movement-quality feedback to patients based on a decision tree which we developed. (shrink)

Children’s and young persons’ rights have received increasing been focus in recent decades, due in a significant degree to the UN Convention on the Rights of the Child. In Sweden, compulsory care in the social-services system is disputed, not least for the forceful measures that facility personnel have at their disposal to control children in certain conflict situations. The general aim of this article is to examine how the increased emphasis in Sweden on children’s rights is promoting resilience for children (...) and youth in youth compulsory secure-care settings. A more general question is whether the child-rights discourse leads in practice to increased resilience for children and youth in this setting, or even in general. The empirical material shows that children and young people’s perceptions of care and treatment are strongly linked to their interactions with staff and how the staff use restrictive measures. Applying Martha Fineman’s vulnerability theory in this context means that achieving resilience demands an analysis of the institutional settings in which children and young persons live their day-to-day lives, including their relationships in this setting. Comparing the legal possibilities of physical constraint with interviews of children and personnel reveals that relevant legislative frameworks and children’s-rights discourse should serve as a protection mechanism for children and youths, but in real life, these seem to have limited effect. (shrink)

The aim of establishing a consistent and unified approach in law concerning the ethics of commercializing human embryos and their derivative parts, products, or related technologies remains incomplete within the European Union. In an attempt to elucidate these problems and implications, I examine three separate moral considerations (i.e., exploitation, commodification, and objectification) that could be used to ground the putative wrongness associated with commercializing stem cells—in particular patenting these materials. It is argued that the moral justification for legal prohibitions on (...) such biological materials for commercial purposes is faced by a number of problematic issues. (shrink)

The article reveals ideological-theoretical, methodological, and politico-ideological basic principles for an adequate analysis of the specifics of modern Chinese (Sinicized) Marxism. The attributive features of modern Chinese Marxism (Marxism with Chinese specifics (the adaptation of Marxism to the Chinese Context, Sinicized Marxism), as the most effective version in world history for correcting and modernizing the axiomatics of the Marxist-Leninist theoretical model of social development, as well as improving the ideology of the ruling Communist Party in order to increase the effectiveness (...) of its domestic and foreign state policies, have been characterized by means of concrete-historical and systematic comparative analysis of the ideational grounds and basic socio-philosophical postulates, political and ideological prescriptions of the program documents of the Communist Party of the Soviet Union and the Communist Party of China. Within the framework of this study, special attention has been paid to highlighting the essence and features of the Soviet and Chinese strategy of socialist construction, created to implement Marxist socialist and communist projects, as well as revealing the scientific evaluation of the differences between the political doctrines of the CPSU and the CPC in the interpretation of objective logic (the duration of stages, goals, and objectives of fundamental economic, social, political, and cultural transformations) of the process of constructing high-level development socialism ("developed socialism") and the further progressive movement of such a society to the phase of communism. (shrink)

The right to conscientious objection in the provision of healthcare is the subject of a lengthy, heated and controversial debate. Recently, a new dimension was added to this debate by the US Supreme Court's decision in Burwell vs. Hobby Lobby et al. which effectively granted rights to freedom of conscience to private, for-profit corporations. In light of this paradigm shift, we examine one of the most contentious points within this debate, the impact of granting conscience exemptions to healthcare providers (...) on the ability of women to enjoy their rights to reproductive autonomy. We argue that the exemptions demanded by objecting healthcare providers cannot be justified on the liberal, pluralist grounds on which they are based, and impose unjustifiable costs on both individual persons, and society as a whole. In doing so, we draw attention to a worrying trend in healthcare policy in Europe and the United States to undermine women's rights to reproductive autonomy by prioritizing the rights of ideologically motivated service providers to an unjustifiably broad form of freedom of conscience. (shrink)

Can we argue that pressures generated from grassroots politics are responsible for the rapid expansion and ethnically/racially uneven distribution of social assistance programs in emerging economies? This article analyzes the Turkish case and shows that social assistance programs in Turkey are directed disproportionately to the Kurdish minority and to the Kurdish region of Turkey, especially to the internally displaced Kurds in urban and metropolitan areas. The article analyzes a cross-sectional dataset generated by a 10,386-informant stratified random sampling survey and controls (...) for possibly intervening socioeconomic factors and neighborhood-level fixed-effects. The results show that high ethnic disparity in social assistance is not due to higher poverty among Kurds. Rather, Kurdish ethnic identity is the main determinant of the access to social assistance. This result yields substantive support to argue that the Turkish government uses social assistance to contain the Kurdish unrest in Turkey. The Turkish government seems to give social assistance not simply where the people become poor, but where the poor become politicized. This provides support for Fox Piven and Cloward’s thesis that relief for the poor is driven by social unrest, rather than social need. The article concludes that similar hypotheses may hold true for other emerging economies, where similar types of social assistance programs have recently expanded significantly and have been directed to ethnic/racial groups. (shrink)

The right to conscientious objection in the provision of healthcare is the subject of a lengthy, heated and controversial debate. Recently, a new dimension was added to this debate by the US Supreme Court's decision in Burwell vs. Hobby Lobby et al. which effectively granted rights to freedom of conscience to private, for-profit corporations. In light of this paradigm shift, we examine one of the most contentious points within this debate, the impact of granting conscience exemptions to healthcare providers (...) on the ability of women to enjoy their rights to reproductive autonomy. We argue that the exemptions demanded by objecting healthcare providers cannot be justified on the liberal, pluralist grounds on which they are based, and impose unjustifiable costs on both individual persons, and society as a whole. In doing so, we draw attention to a worrying trend in healthcare policy in Europe and the United States to undermine women's rights to reproductive autonomy by prioritizing the rights of ideologically motivated service providers to an unjustifiably broad form of freedom of conscience. (shrink)

Both healthcare professionals and the healthcare system must defend each patient's health individually while simultaneously seeking to protect the population's health in general. Nowadays, there is an important increase in the cost of healthcare supply, mainly due to the developments of medical science, the public's expectations and the demographic ageing. Since healthcare resources are not unlimited, it is obvious that immoderate consumption of them by certain patients limits the use of the same funds by others. Therefore, we have to seek (...) an optimal distribution of the existing resources in order to manage a constriction of expenses, especially under the circumstances of the modern economic crisis. The criteria of effectiveness and efficiency should be used. Health policies focus on both the public's behaviour and the rules of medical practice. Under the modern challenges the physician's role is particularly important for the protection of the patient's health and the promotion of public health. (shrink)

The way in which a nation’s economy is structured is of great importance for the material welfare of its people as well as the people’s relationship with the state and the operation of the state itself. It is also important for the proper functioning of a nation as a people and its psychological welfare. If the gap between rich and poor increases, the structure of an economy, and therefore the welfare of the state and the nation, is at risk. Two (...) important documents of antiquity, Plato’s Nomoi and the Book of Deuteronomy, which even today influence life, dealt intensively with the fissures between rich and poor within society as a danger to political welfare and harmony. This article will examine these documents to make use of these two books for improving a societal situation. This will be done by a comparative perspective on both of these books. (shrink)

M. Römeris’s constant endeavour and experience were gained from his studies in the various universities of different countries. Presiding over eminent experts and established professors-educationalists of his day aided in M. Römeris’s mastery of pedagogics.One of the most fundamental academic provisions of M. Römeris was that the relations between university professors and students had to be built on mutual respect and reliance. In his belief, the professor is obligated to earn the respect and the fondness of students through his valuable (...) work, both as a scholar and as a human being. M. Römeris rendered this exclusive consideration in the study process during his lectures. In his belief, a lively speech could never be replaced by books. Even having given lectures for the same course of Constitutional Law for years, M. Römeris used to prepare for the lectures very thoroughly, constantly, and improved and updated them. His lectures were thorough and widely and deeply analysed problems. (shrink)

ABSTRACT Conventions on human rights give priority to parents in education but modern states tend to make uniform provision, tending towards a monopoly position. Education itself is not incompatible with liberty but is a condition of it. A three-sided conflict exists, however, between the state, parents and professionals as to who should represent the interests of children. Liberty is best preserved if the conflict is resolved in favour of parents, for only parental decision-making guarantees educational variety and change. In (...) addition, the parental relationship itself generates rights, including one derived from the broader political right to cultural and religious freedom. (shrink)

We argue that, in certain circumstances, doctors might beprofessionallyjustified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best (...) medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal ofRoe v Wade. (shrink)