In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps (...) capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks. (shrink)

We uncover a largely unnoticed and unaddressed problem in conservation research: arguments built within studies are sometimes defective in more fundamental and specific ways than appreciated, because they misrelate values and empirical matters. We call this the unraveled rope problem because just as strands of rope must be properly and intricately wound with each other so the rope supports its load, empirical aspects and value aspects of an argument must be related intricately and properly if the argument is to objectively (...) support its conclusion. By characterizing this problem with precision, our study differs from but complements existing studies of value issues in conservation science, in two ways. First, it focuses on key relationships between empirical issues and value issues, relations that have sometimes been obscured by focusing on these issues more independently of each other. Second, it focuses on these relationships within arguments and deploys a method of argument analysis and evaluation honed in other fields but under-utilized in conservation science. By combining our study's novel features, we detail six families of argument defect that exemplify the unraveled rope problem within existing literature. These defects sometimes manifest within basic research stages, rather than just in more applied downstream stages where roles for values are already obvious to many. As scientific reasoning and communication become increasingly important for addressing society's greatest environmental challenges, overcoming the unraveled rope problem will be essential to the success and integrity of conservation research. Therefore, we also outline potential solutions, preventative measures, and useful further work for conservation researchers. (shrink)

Alternative food networks are emerging in opposition to industrial food systems, but are criticized as being exclusive, since customers’ ability to patronize these market spaces is premised upon their ability to pay higher prices for what are considered the healthiest, freshest foods. In response, there is growing interest in widening the demographic profile given access to these alternative foods. This research asks: what barriers do alternative food businesses face in providing access and inclusion for low income consumers? Surveys and interviews (...) with 45 alternative food businesses in British Columbia, Canada uncovered five key barriers. The findings indicate that the barriers are symptomatic of structural issues in the Canadian food and social welfare systems. Although opportunities exist for business operators to widen access for low income shoppers, these alone cannot meaningfully ameliorate food-access inequality. Rather, these barriers underscore issues of income-disparity, poverty, and food-access inequality more broadly, and require structural and societal change to rectify. (shrink)

Clear guidelines addressing the ethically appropriate use of anti-infectives in the setting of hospice care do not exist. There is lack of understanding about key treatment decisions related to infection treatment for patients who are eligible for hospice care. Ethical concerns about anti-infective use at the end of life include: (1) delaying transition to hospice, (2) prolonging a dying process, (3) prescribing regimens incongruent with a short life expectancy and goals of care, (4) increasing the reservoir of potential resistant pathogens, (...) (5) placing unreasonable costs on a capitated hospice system. Although anti-infectives are thought to be relatively safe, they can place a burden on patients and be inconsistent to particular care plans. The current complex, and at times fragmented, medical care often fails to address these issues in decision-making. In many ways, the ethics governing the end of life decisions related to dialysis, hydration/nutrition, and hypercalcemia parallel those of anti-infectives. In this article we articulate important elements in ethical decision-making in the application of anti-infectives for patients who are eligible for hospice care, and we point to the need for prospective studies to help refine particular guidelines in these cases. (shrink)

ABSTRACT Clear guidelines addressing the ethically appropriate use of anti‐infectives in the setting of hospice care do not exist. There is lack of understanding about key treatment decisions related to infection treatment for patients who are eligible for hospice care. Ethical concerns about anti‐infective use at the end of life include: (1) delaying transition to hospice, (2) prolonging a dying process, (3) prescribing regimens incongruent with a short life expectancy and goals of care, (4) increasing the reservoir of potential resistant (...) pathogens, (5) placing unreasonable costs on a capitated hospice system. Although anti‐infectives are thought to be relatively safe, they can place a burden on patients and be inconsistent to particular care plans. The current complex, and at times fragmented, medical care often fails to address these issues in decision‐making. In many ways, the ethics governing the end of life decisions related to dialysis, hydration/nutrition, and hypercalcemia parallel those of anti‐infectives. In this article we articulate important elements in ethical decision‐making in the application of anti‐infectives for patients who are eligible for hospice care, and we point to the need for prospective studies to help refine particular guidelines in these cases. (shrink)

White matter tracts are known to be susceptible to injury following concussion. The objective of this study was to determine whether contact play in sport could alter white matter metabolite levels in female varsity athletes independent of changes induced by long-term exercise. Metabolite levels were measured by single voxel proton magnetic resonance spectroscopy in the prefrontal white matter at the beginning and end of season in contact and non-contact varsity athletes. Sedentary women were scanned once, at a time equivalent to (...) the Off-Season time point. Metabolite levels in non-contact athletes did not change over a season of play, or differ from age matched sedentary women except that non-contact athletes had a slightly lower myo-inositol level. The contact athletes had lower levels of myo-inositol and glutamate, and higher levels of glutamine compared to both sedentary women and non-contact athletes. Lower levels of myo-inositol in non-contact athletes compared to sedentary women indicates long-term exercise may alter glial cell profiles in these athletes. The metabolite differences observed between contact and non-contact athletes suggest that non-contact athletes should not be used as controls in studies of concussion in high-impact sports because repetitive impacts from physical contact can alter white matter metabolite level profiles. It is imperative to use athletes engaged in the same contact sport as controls to ensure a matched metabolite profile at baseline. (shrink)

Recent developments toward a more holistic biology do not eliminate reductionism and determinism, but they do suggest more complex forms of them, in which there are multiple, interacting influences, as there are in complex or chaotic systems. Though there is a place in biology for both systemic and atomistic modes of explanation, for those with a theological perspective the shift to complex explanations in biology is often welcome. It suggests a more subtle view of divine action in which God's purposes (...) are affected through engagement with the complex systems of creation rather than by discrete interventions. It also invites us to connect the biological interdependence with the interdependence in the nature and purposes of God, and it is consonant with a mystical vision of the unity of all things. (shrink)

This case series presents two general practice cases where HIV testing occurred, or results suggestive of HIV were received, before informed consent was obtained. Bioethical and professional principles are used to explore these dilemmas.

Frank Plumpton Ramsey (1903–30) made seminal contributions to philosophy, mathematics and economics. Whilst he was acknowledged as a genius by his contemporaries, some of his most important ideas were not appreciated until decades later; now better appreciated, they continue to bear an influence upon contemporary philosophy. His historic significance was to usher in a new phase of analytic philosophy, which initially built upon the logical atomist doctrines of Bertrand Russell and Ludwig Wittgenstein, raising their ideas to a new level of (...) sophistication, but ultimately he became their successor rather than remain a mere acolyte. (shrink)

Background: Health researchers must weigh the benefits and risks of publishing their findings.Objective: To explore differences in decision making between rural health researchers and managers on the publication of research from small identifiable populations.Method: A survey that investigated the attitudes of Australian rural general practitioners to nurse practitioners was explored. Decisions on the study’s publication were analysed with bioethical principles and health service management ethical decision-making models.Results: Response rate was 78.5% . 84–94% of GP responders considered it to be undesirable (...) for nurse practitioners to initiate referrals to medical specialists , to initiate diagnostic imaging and to prescribe medication .Bioethical analysis: It was concluded that the principle of beneficence outweighed the principle of non-maleficence and that a valid justification for the publication of these results existed.Decision-making models of health service managers: On the basis of models of ethical decision making in health service management, the decisions of the area’s health managers resulted in approval to publish this project’s results being denied. This was because the perceived risks to the health service outweighed benefits. Confidentiality could not be ensured by publication under a regional nom de plume.Conclusions: A conflict of interests between rural researchers and health managers on publication of results is shown by this case study. Researchers and managers at times owe competing duties to key stakeholders. Both weigh the estimated risks and benefits of the effect of research findings. This is particularly true in a rural area, where identification of the subjects becomes more likely. (shrink)

The present state of ethical theory and practice is disquieting. Objectivism, in all its varieties, is unconvincing, and subjectivism, hedonic or emotive, is intellectually incredible and socially intolerable. No one is ethically content—except the dogmatist and the sceptic, who act willy nilly with the exponents of “might-cum-persuasion makes right.” Can we find a happier middle region between these inhospitable poles? Perhaps the very limitations of human valuation will provide the ground that ethics requires. Let us begin by considering the conditions (...) which must hold if ethical action is to be possible: 1. Only if the agent can provide a justifying reason for his choice of action can he claim to act ethically. For ethical action is a species of purposive action, and to act purposively entails the ability to give justifying reasons for one's choice of action. . Thus ethical action presupposes putatively grounded ethical judgment. 2. Justifying reasons must be acknowledgeable by all competent judges, i.e. by all persons who are acquainted with all relevant knowledge of the nature and consequences of the alternative courses of action, allow as far as possible for congenital, cultural and idiosyncratic bias, are capable of sane and serious reflection, and are able to make survey of their experience and to draw conclusions from it. For the judgment “the action A is ethically preferable to its alternatives B ” entails “A ought to be done” which in turn entails “every competent judge is capable of acknowledging the ground of the judgment ‘A is ethically preferable to B’ and consequently would be able to set himself to perform A as an ethical act, .” We can assure ourselves of this requirement of acknowledgeability by observing that whenever we resolve, and not merely settle, an ethical disagreement, we have achieved not only a factual, predictive, valuational and attitudinal agreement between the disputants, but a joint acknowledgment of the ground of the ethical judgment. Without this, the agreement could not be said to be ethical, whether the judgment be right or wrong or neither, but merely an agreement to disagree, ethically. Unless ethical disagreement is in principle resolvable, ethical judgment is impossible, for we should be unable to claim that our choice ought to be acted upon. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Leading philosophers and social thinkers, including Richard Rorty, Jacques Derrida, and Jurgen Habermas, pay tribute to the influential American philosopher Richard J. Bernstein.

The First Conference of the International Society for the Study of Time was held at the Mathematisches Forschungsinstitut at Oberwolfach in the Black Forest, Federal Republic of Germany from Sunday, 31 August to Saturday, 6 September, 1969. The origin of this conference and the formation of the Society goes back to a proposal due to J. T. Fraser that was discussed at a conference on "Interdisciplinary Perspectives of Time" held by the New York Academy of Sciences in January, 1966. (...) It was unanimously agreed than that an international society should be formed on an interdisciplinary basis with the object of stimulating interest in all problems concerning 'time and that this object could best be attained by means of conferences held at regular intervals. J. T. Fraser was elected Secretary, S. Watanabe Treasurer, and I was elected President. It was agreed, at my suggestion, that the organization of the first conference of the newly formed Society be left to a committee of these three officers, on the understanding that they would invite authorities on the role of time in the various special sciences and humanities to form an Advisory Board to assist them. One of the main difficulties in seeking support for an interdisciplinary conference is that most foundations confine their interest exclusively either to the sciences or to the humanities. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

The papers in this volume reflect much of the current unease of a world that perceives itself once more at the edge of chaos. The authors present different vistas of that experience and their inherent dialectic, expressed in numerous and ceaseless conflicts between ordering and disordering processes. They can be read as comments on the ongoing processes that lead toward greater complexity.