Social epidemiology has made a powerful case that health determined not just by individual-level factors such as our genetic make-up, access to medical services, or lifestyle choices, but also by social conditions, including the economy, law, and culture. Indeed, at the level of populations, evidence suggests that these “structural” factors are the predominant influences on health. Legal scholars in public health, including those in the health and human rights movement, have contended that human rights, laws, and legal practices are powerfully (...) linked to health. Social epidemiology and health-oriented legal scholarship are complementary in their focus and their research needs. Legal scholarship has identified plausible ways in which legal and human rights factors could be influencing health, but empirical evidence has been limited. (shrink)

Assessing social risks has proven difficult for IRBs. We undertook a novel effort to empirically investigate social risks before an HIV prevention trial among drug users in Thailand and China. The assessment investigated whether law, policies and enforcement strategies would place research subjects at significantly elevated risk of arrest, incarceration, physical harm, breach of confidentiality, or loss of access to health care relative to drug users not participating in the research. The study validated the investigator's concern that drug users were (...) subject to serious social risks in the site localities, but also suggested that participation in research posed little or no marginal increase in risk and might even have a protective effect. Our experience shows that it is feasible to inform IRB deliberations with actual data on social risks, but also raises the question of whether and when such research is an appropriate use of scare research resources. (shrink)

No one who attended the 2010 national public health law conference hosted by the Public Health Law Association and the American Society of Law, Medicine & Ethics could miss the sense of excitement and momentum. The revival of this annual public health law meeting, with the support of the Robert Wood Johnson Foundation, the energetic leadership of the PHLA president and board, ASLME’s expert guidance, and a rousing address by Dr. Tom Frieden, Director of the Centers for Disease Control and (...) Prevention, symbolize the continued commitment of a wide range of important individuals and institutions to the proposition that law is of substantial importance to public health. But there is more than just symbolism to be excited about. CDC’s public health law program continues to champion efforts to promote the use and understanding of law as a public health tool. (shrink)

No one who attended the 2010 national public health law conference hosted by the Public Health Law Association and the American Society of Law, Medicine & Ethics could miss the sense of excitement and momentum. The revival of this annual public health law meeting, with the support of the Robert Wood Johnson Foundation, the energetic leadership of the PHLA president and board, ASLME’s expert guidance, and a rousing address by Dr. Tom Frieden, Director of the Centers for Disease Control and (...) Prevention, symbolize the continued commitment of a wide range of important individuals and institutions to the proposition that law is of substantial importance to public health. But there is more than just symbolism to be excited about. CDC’s public health law program continues to champion efforts to promote the use and understanding of law as a public health tool. (shrink)

Stigma has become an important concept in public health law. It is widely accepted that certain diseases are disfavored in society, leading to discrimination against people identified with them, which in turn has the tendency to drive an epidemic underground—i.e., to make it more difficult for voluntary public health programs to reach and succeed among populations bent on concealing their disease or risk status. The need to reduce stigma and its effects has been used to justify the passage of privacy (...) and antidiscrimination law to protect people with HIV. More recently, stigma has been part of the arsenal of justification for special genetic antidiscrimination and privacy law. Despite its importance, however, there is no single widely accepted definition of stigma in social science, and its relationship to law has been generally under-theorized and unsupported by data, reducing our ability to effectively deploy law and other tools in the anti-stigma cause. (shrink)

With the publication of the final report of the WHO Commission on the Social Determinants of Health, it becomes clear that there is considerable convergence between a policy agenda rooted on social epidemiology and one rooted in a concern for human rights. As commentators like Jonathan Mann have argued, concern for human rights and the achievement of social justice can inform and improve public health. In this article, we ask a different question: what does a health perspective adds to the (...) enduring fight for a more just world? We consider three possibilities: (1) that public health, in an inversion of Mann's argument, actually provides useful tools for specifying social injustice; (2) that, contrary to the usual critical stance and assumption of weakness, the institutions of public health bring powerful capacities to the practical promotion of social justice; and (3) that health as a banner mobilizes people who would not be mobilized to act in the name of social justice. (shrink)

With the publication of the final report of the WHO Commission on the Social Determinants of Health, it becomes clear that there is considerable convergence between a policy agenda rooted on social epidemiology and one rooted in a concern for human rights. As commentators like Jonathan Mann have argued, concern for human rights and the achievement of social justice can inform and improve public health. In this article, we ask a different question: what does a health perspective adds to the (...) enduring fight for a more just world? We consider three possibilities: (1) that public health, in an inversion of Mann's argument, actually provides useful tools for specifying social injustice; (2) that, contrary to the usual critical stance and assumption of weakness, the institutions of public health bring powerful capacities to the practical promotion of social justice; and (3) that health as a banner mobilizes people who would not be mobilized to act in the name of social justice. (shrink)

Stigma has become an important concept in public health law. It is widely accepted that certain diseases are disfavored in society, leading to discrimination against people identified with them, which in turn has the tendency to drive an epidemic underground—i.e., to make it more difficult for voluntary public health programs to reach and succeed among populations bent on concealing their disease or risk status. The need to reduce stigma and its effects has been used to justify the passage of privacy (...) and antidiscrimination law to protect people with HIV. More recently, stigma has been part of the arsenal of justification for special genetic antidiscrimination and privacy law. Despite its importance, however, there is no single widely accepted definition of stigma in social science, and its relationship to law has been generally under-theorized and unsupported by data, reducing our ability to effectively deploy law and other tools in the anti-stigma cause. (shrink)

Criminal law is one of the regulatory tools being used in the United States to influence risk behavior by people who have HIV/AIDS. Several different types of laws have been or could be used in this way These include:HIV-specific exposure and transmission laws — i.e., laws that explicitly mention and exclusively apply to conduct by people with HIV;public health statutes prohibiting conduct that would expose others to communicable diseases and/or sexually transmitted diseases ; andgeneral criminal laws governing attempted murder and (...) assault. (shrink)

Criminal law is one of the regulatory tools being used in the United States to influence risk behavior by people who have HIV/AIDS. Several different types of laws have been or could be used in this way These include:HIV-specific exposure and transmission laws — i.e., laws that explicitly mention and exclusively apply to conduct by people with HIV;public health statutes prohibiting conduct that would expose others to communicable diseases and/or sexually transmitted diseases ; andgeneral criminal laws governing attempted murder and (...) assault. (shrink)

One understanding of health conceives of it as a state of freedom from pathology, achieved by an individual, through the mediation of a doctor. On this view, improvements in health flow from the application of science to specific ills of the body, and access to medical care is the chief determinant of health. This “medicalized” view of health underlies the current debate over medical care payment reform. This is the dominant way of talking about health.An alternative is the view of (...) health commonly associated with the practice of public health. On this view, health is an attribute of communities in social and physical environments. Health takes its shape in large numbers—in morbidity and mortality statistics—and, ideally, includes not just a high level of well-being for some, but also its even distribution throughout a society. Improvements in health are seen to arise from healthful changes in the environment. (shrink)

“Public health practice” consists of activities and Programs managed by public health agencies to promote health and prevent disease, injury, and disability. Some of these activities might be deemed to fit within the broad definition of “research” under federal regulations, known as the Common Rule, designed to protect human research subjects. The Common Rule defines research as “a systeniatic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge.” Public health activities that might under some (...) circumstances be considered research include disease reporting, review of medical records, surveys, interviews, focus groups, specimen collection, and laboratory testing.There are questions about the extent to which the Common Rule applies or was intended to apply to public health practice: and it has been suggested in any case that Common Rule regulation of public health practice may not be socially optimal for both practical and principled reasons. (shrink)

“Public health practice” consists of activities and Programs managed by public health agencies to promote health and prevent disease, injury, and disability. Some of these activities might be deemed to fit within the broad definition of “research” under federal regulations, known as the Common Rule, designed to protect human research subjects. The Common Rule defines research as “a systeniatic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge.” Public health activities that might under some (...) circumstances be considered research include disease reporting, review of medical records, surveys, interviews, focus groups, specimen collection, and laboratory testing.There are questions about the extent to which the Common Rule applies or was intended to apply to public health practice: and it has been suggested in any case that Common Rule regulation of public health practice may not be socially optimal for both practical and principled reasons. (shrink)

No one questions the importance of protecting human subjects of research, but over the past few years dissatisfaction has surfaced with the manner in which the protection is conferred by the federal regulatory system referred to as “The Common Rule. ” Some of the criticism surfaces in print. Some bubbles out anecdotally in conversations among researchers, with complaints about the review process being virtually inevitable whenever the topic arises. Like those in other disciplines that differ more or less dramatically from (...) the world of clinical medical research around which the Common Rule was conceptualized, public health researchers, particularly those working in official public health agencies, have experienced some tension and difficulty in adapting to the rules. The Centers For Disease Control and Prevention has adopted guidelines that require Common Rule review for “research” but not “practice” activities. (shrink)

No one questions the importance of protecting human subjects of research, but over the past few years dissatisfaction has surfaced with the manner in which the protection is conferred by the federal regulatory system referred to as “The Common Rule. ” Some of the criticism surfaces in print. Some bubbles out anecdotally in conversations among researchers, with complaints about the review process being virtually inevitable whenever the topic arises. Like those in other disciplines that differ more or less dramatically from (...) the world of clinical medical research around which the Common Rule was conceptualized, public health researchers, particularly those working in official public health agencies, have experienced some tension and difficulty in adapting to the rules. The Centers For Disease Control and Prevention has adopted guidelines that require Common Rule review for “research” but not “practice” activities. (shrink)

One understanding of health conceives of it as a state of freedom from pathology, achieved by an individual, through the mediation of a doctor. On this view, improvements in health flow from the application of science to specific ills of the body, and access to medical care is the chief determinant of health. This “medicalized” view of health underlies the current debate over medical care payment reform. This is the dominant way of talking about health.An alternative is the view of (...) health commonly associated with the practice of public health. On this view, health is an attribute of communities in social and physical environments. Health takes its shape in large numbers—in morbidity and mortality statistics—and, ideally, includes not just a high level of well-being for some, but also its even distribution throughout a society. Improvements in health are seen to arise from healthful changes in the environment. (shrink)

Assessing social risks has proven difficult for IRBs. We undertook a novel effort to empirically investigate social risks before an HIV prevention trial among drug users in Thailand and China. The assessment investigated whether law, policies and enforcement strategies would place research subjects at significantly elevated risk of arrest, incarceration, physical harm, breach of confidentiality, or loss of access to health care relative to drug users not participating in the research. The study validated the investigator's concern that drug users were (...) subject to serious social risks in the site localities, but also suggested that participation in research posed little or no marginal increase in risk and might even have a protective effect. Our experience shows that it is feasible to inform IRB deliberations with actual data on social risks, but also raises the question of whether and when such research is an appropriate use of scare research resources. (shrink)

The prelims comprise: Introduction Public Health Ethics The Public Health Interest in Genetic Screening Discussion Conclusion.

Few now question that population health is significantly shaped by social ecology. Power, wealth, and social status clearly matter: Their enactment in daily life makes them fundamental social determinants of health. Important as it is that we accept the broad importance of social factors in health, it is not enough. Our current grasp of the importance of social factors in health has to be strengthened by research that more precisely delineates the workings of social health through social processes, and the (...) investment in research must in turn be vindicated by interventions that make a difference. The work presented in this issue of the Journal of Law, Medicine & Ethics is intended to advance the agenda for research and action.An ecological theory puts health everywhere. Population health is shaped in the hierarchies of the workplace, the neighborhood, and the home. (shrink)

The provision of police services and the suppression of crime is one of the first functions of civil government. Article 3 of the Universal Declaration of Human Rights speaks of a right to “security of person.” “The term ‘police’ traditionally connoted social organization, civil authority, or formation of a political community—the control and regulation of affairs affecting the general order and welfare of society,” including the protection of public health. Civil dispute resolution is also an important part of a system (...) that moves people away from self-help and toward reliance on collectively constituted, peaceful channels for working out problems.A safe and secure environment is tied to health. Research in social epidemiology suggests that a shared sense of security from physical violence and interference with property can contribute to better community health. (shrink)

Drug overdose has recently surpassed motor vehicle accidents to become the leading cause of unintentional injury death in the United States. The epidemic is largely driven by opioids such as oxycodone, hydrocodone, and methadone, which kill more Americans than heroin and cocaine combined. The demographics of overdose have changed over the past few decades as well: according to the latest data, the average overdose victim is now a non-Hispanic white man aged 45-54.These deaths — over 16,000 per year — are (...) almost entirely preventable. Opioid overdose kills by slowly depressing respiration, a process that can take several hours. It can be quickly and effectively reversed by the timely administration of naloxone, an opioid antagonist that works by displacing opioids from the brain receptors to which they attach, reversing their depressant effect. Naloxone, also known as Narcan, has many benefits and minimal risks. Although it is a prescription drug, it is not a controlled substance and has no abuse potential. (shrink)

Over two hundred years ago, Thomas Jefferson suggested the need for a broader legal curriculum. As the twenty-first century begins, the practice of law will increasingly demand interdisciplinary knowledge and collaboration — between those trained in law and a broad range of scientific and technical fields, including engineering, biology, genetics, ethics, and the social sciences. The practice of public health law provides a model for both the substantive integration of law with science, and for the way its practitioners work. In (...) addition, public health law also provides a model for interdisciphuy and integrative teaching. (shrink)

Over two hundred years ago, Thomas Jefferson suggested the need for a broader legal curriculum. As the twenty-first century begins, the practice of law will increasingly demand interdisciplinary knowledge and collaboration — between those trained in law and a broad range of scientific and technical fields, including engineering, biology, genetics, ethics, and the social sciences. The practice of public health law provides a model for both the substantive integration of law with science, and for the way its practitioners work. In (...) addition, public health law also provides a model for interdisciphuy and integrative teaching. (shrink)

Surveillance in public health is the means by which people who are responsible for preventing or controlling threats to health get the timely, ongoing, and reliable information they need about the occurrence, antecedents, time course, geographic spread, consequences, and nature of these threats among the populations they serve. “Policy surveillance” is the ongoing, systematic collection, analysis, and dissemination of information about laws and other policies of health importance.

The ability to judge accurately whether or not an action can be accomplished successfully is critical for selecting appropriate response options that enable adaptive behaviors. Such affordance judgments are thought to rely on the perceived fit between environmental properties and knowledge of one's current physical capabilities. Little, however, is currently known about the ability of individuals to judge their own affordances following a stroke, or about the underlying neural mechanisms involved. To address these issues, we employed a signal detection approach (...) to investigate the impact of left or right hemisphere injuries on judgments of whether a visual object was located within reach while remaining still. Regarding perceptual sensitivity and accuracy in judging reachability, there were no significant group differences between healthy controls, right brain damaged and left brain damaged stroke patients. However, while healthy controls and RBD patients demonstrated a negative response criterion and thus overestimated their reach capability, LBD patients' average response criterion converged to zero, indicating no judgment tendency. Critically, the LBD group's judgment tendency pattern is consistent with previous findings in this same sample on an affordance judgment task that required estimating whether the hand can fit through apertures. Lesion analysis suggests that this loss of judgment tendency may be associated with damage to the left insula, the left parietal and middle temporal lobe. Based on these results, we propose that damage to the left ventro-dorsal stream disrupts the retrieval and processing of a stable criterion, leading to stronger reliance on intact on-line body-perceptive processes computed within the preserved bilateral dorsal network. (shrink)

Scott Yenor argues that David Hume's reputation as a skeptic is greatly exaggerated. In David Hume's Humanity, Yenor shows how Hume's skepticism is a moment leading Hume to defend a philosophy that is grounded in the inescapable assumptions of common life. Humane virtues reflect the proper reaction to the complex mixture of human faculties that define the human condition. These gentle virtues best find their home in the modern commercial republic, of which England is the leading example. Hume's defense (...) of both common life philosophy and humanity are, however, flawed by his secretly dogmatic assumptions about the nature of history and his Enlightened approach to religious teachings and psychology. This study makes the case for Hume's manner of grounding philosophy in common life is essential to any reinvigoration of the humanities. It ultimately holds that Hume's practice of that philosophy is seriously flawed, but that a more philosophic philosophy of common life is available. (shrink)

Imagine that, through no fault of your own, you nd yourself at the bottom of a deep well. Thugs have picked up an innocent person | call him Bob | and have thrown him down the well. Bob is now falling towards you. If you do nothing, your body will cushion Bob's otherwise lethal fall. This will guarantee his survival, but it will kill you. If you shoot your ray gun, you vaporize and kill Bob, thereby saving your life. Are (...) you morally permitted to shoot your ray gun?Most people believe that self-defence against an innocent threat such as Bob is permissible. Judith Thomson (1991) and Frances Kamm (1987) have tried to justify this widely held belief. Jeff McMahan (2002) and Michael Otsuka (1994) have argued against it. In this paper, I contend that arguments from both sides of the debate mistakenly take the existence of an important asymmetry between Bob and you for granted. That way, they miss how similar Bob and you are, in that both of you happen to nd yourselves, undeservingly and through no fault of your own, in a situation in which you can secure your own survival only if you kill an innocent person. In this paper, I argue that despite certain differences, we are justi ed in focusing on the simliarities between Bob and you, and that you should thus flip a coin to decide who should live (cf. Broome, 1991). By flipping a coin, you ensure that an indivisible good -- continuing one's life -- is distributed as fairly as is possible without wasting it. (shrink)

Looking back, the moral panic that precipitated the decimation of horror comics in the 1950s seems quaint, yet concerns about the psychological impact of violent media on consumers have never disappeared. In this article, I outline a particular type of psychological impact we ought to take seriously when evaluating the moral status of entertainment. I then consider (a) ways in which comics seem immune from claims that they create this kind of impact for their readers, as well as (b) ways (...) in which we might think that comics generate special instances of moral danger for readers. (shrink)

In video games, identification with avatars—virtual entities or characters driven by human behavior—has been shown to serve many interpersonal and intraindividual functions but our understanding of the psychological variables that influence players' avatar choices remains incomplete. The study presented in this paper tested whether players' preferred style of avatar creation is linked to the magnitude of self-perceived discrepancies between who they are, who they aspire to be, and who they think they should be. One-hundred-and-twenty-five undergraduate gamers indicated their preferred avatar (...) creation style and completed a values measure from three different perspectives: their actual, ideal, and ought selves. The average actual/ideal values discrepancy was greater among those who preferred idealized avatars vs. those who preferred realistic avatars. The average actual/ought values discrepancy was greater among those who preferred completely different avatars vs. those who preferred realistic avatars. These results, therefore, offer additional evidence that self-discrepancy theory is a useful framework for understanding avatar preferences. (shrink)

We propose a multi-step evaluation schema designed to help procurement agencies and others to examine the ethical dimensions of autonomous systems to be applied in the security sector, including autonomous weapons systems.

This chapter discusses the roles of ether and electrons in relativity theory. One of the most radical moves made by Albert Einstein was to dismiss the ether from electrodynamics. His fellow physicists felt challenged by Einstein’s view, and they came up with a variety of responses, ranging from enthusiastic approval, to dismissive rejection. Among the naysayers were the electron theorists, who were unanimous in their affirmation of the ether, even if they agreed with other aspects of Einstein’s theory of relativity. (...) The eventual success of the latter theory (circa 1911) owed much to Hermann Minkowski’s idea of four-dimensional spacetime, which was portrayed as a conceptual substitute of sorts for the ether. (shrink)

The paper addresses the situation of a dispute in which one speaker says ϕ and a second speaker says not-ϕ. Proceeding on an idealising distinction between “basic” and “interesting” claims that may be formulated in a given idiolectal language, I investigate how it might be sorted out whether the dispute reflects a genuine disagreement, or whether the speakers are only having a merely verbal dispute, due to their using different interesting concepts. I show that four individually plausible principles for the (...) determination of the nature of a dispute are incompatible. As an example, I discuss the question whether Sarai lied in the story told in Genesis 12. (shrink)

This ambitious, interdisciplinary book seeks to explain the origins of religion using our knowledge of the evolution of cognition. A cognitive anthropologist and psychologist, Scott Atran argues that religion is a by-product of human evolution just as the cognitive intervention, cultural selection, and historical survival of religion is an accommodation of certain existential and moral elements that have evolved in the human condition.

The law of gravitational attraction is a window on three formal approaches to laws of nature based on Lorentz-invariance: Poincaré’s four-dimensional vector space (1906), Minkowski’s matrix calculus and spacetime geometry (1908), and Sommerfeld’s 4-vector algebra (1910). In virtue of a common appeal to 4-vectors for the characterization of gravitational attraction, these three contributions track the emergence and early development of four-dimensional physics.

In the last decade, the familiar problem of the regress of reasons has returned to prominent consideration in epistemology. And with the return of the problem, evaluation of the options available for its solution is begun anew. Reason’s regress problem, roughly put, is that if one has good reasons to believe something, one must have good reason to hold those reasons are good. And for those reasons, one must have further reasons to hold they are good, and so a regress (...) of reasons looms. In this new study, Aikin presents a full case for infinitism as a response to the problem of the regress of reasons. Infinitism is the view that one must have a non-terminating chain of reasons in order to be justified. The most defensible form of infinitism, he argues, is that of a mixed theory – that is, epistemic infinitism must be consistent with and integrate other solutions to the regress problem. (shrink)

Science and the originality of life -- Christian facticity -- Grasping life as a topic -- Ruinance -- The retrieval of history -- Facticity and ontology -- Factical speaking -- Rhetoric -- Sophistry.

A generative grammar for a language L generates one or more syntactic structures for each sentence of L and interprets those structures both phonologically and semantically. A widely accepted assumption in generative linguistics dating from the mid-60s, the Generative Grammar Hypothesis, is that the ability of a speaker to understand sentences of her language requires her to have tacit knowledge of a generative grammar of it, and the task of linguistic semantics in those early days was taken to be that (...) of specifying the form that the semantic component of a generative grammar must take. Then in the 70s linguistic semantics took a curious turn. Without rejecting GGH, linguists turned away from the task of characterizing the semantic component of a generative grammar to pursue instead the Montague-inspired project of providing for natural languages the same kind of model-theoretic semantics that logicians devise for the artificial languages of formal systems of logic, and “formal semantics” continues to dominate semantics in linguistics. This essay argues that the sort of compositional meaning theory that would verify GGH would not only be quite different from the theories formal semanticists construct, but would be a more fundamental theory that supersedes those theories in that it would explain why they are true when they are true, but their truth wouldn’t explain its truth. Formal semantics has undoubtedly made important contributions to our understanding of such phenomena as anaphora and quantification, but semantics in linguistics is supposed to be the study of meaning. This means that the formal semanticist can’t be unconcerned that the kind of semantic theory for a natural language that interests her has no place in a theory of linguistic competence; for if GGH is correct, then the more fundamental semantic theory is the compositional meaning theory that is the semantic component of the internally represented generative grammar, and if that is so, then linguistic semantics has so far ignored what really ought to be its primary concern. (shrink)

This book analyses the straw man fallacy and its deployment in philosophical reasoning. While commonly invoked in both academic dialogue and public discourse, it has not until now received the attention it deserves as a rhetorical device. Scott Aikin and John Casey propose that straw manning essentially consists in expressing distorted representations of one's critical interlocutor. To this end, the straw man comprises three dialectical forms, and not only the one that is usually suggested: the straw man, the weak (...) man and the hollow man. Moreover, they demonstrate that straw manning is unique among fallacies as it has no particular logical form in itself, because it is an instance of inappropriate meta-argument, or argument about arguments. They discuss the importance of the onlooking audience to the successful deployment of the straw man, reasoning that the existence of an audience complicates the dialectical boundaries of argument. Providing a lively, provocative and thorough analysis of the straw man fallacy, this book will appeal to postgraduates and researchers alike, working in a range of fields including fallacies, rhetoric, argumentation theory and informal logic. (shrink)