Recent evidence confirming that the administration of antiretroviral drugs (ARVs) to HIV‐infected persons may effectively reduce their risk of transmission has revived the discussion about priority setting in the fight against HIV/AIDS. The fact that the very same drugs can be used both for treatment purposes and for preventive purposes (Treatment as Prevention) has been seen as paradigm‐shifting and taken to spark a new controversy: In a context of scarce resources, should the allocation of ARVs be prioritized based on the (...) goal of providing treatment, or on the goal of preventing the spread of the HIV epidemic?Contributions to this discussion tend to assume that treatment and prevention constitute two divergent goals that entail conflicting priorities. We challenge that assumption on the basis of both conceptual and empirical examination. We argue that, as far as the provision of ARVs to HIV‐infected persons is concerned, the goals of treatment and prevention do not entail conflicting priorities; to the contrary, they dictate converging strategies for the optimal allocation of ARVs. In light of the current evidence, the concept of Treatment as Prevention can indeed be seen as paradigm‐shifting, yet in a novel way: Rather than extending the tension between the goals of treatment and prevention to the level of drug‐allocation, it dissolves this tension by providing a rationale for a unified strategy for allocating ARVs. (shrink)

The reform of the health care system will include a mandate: Individuals are required to purchase health insurance provided that affordable options are available. But what is affordable health insurance? Three accounts of affordability of health coverage have been advanced. The first two accounts are empirical. The third account is needs-based. All three accounts are inadequate. I propose a fourth, the reasonable tradeoff account, according to which individuals should only be required to make reasonable tradeoffs in order to pay for (...) their health coverage. That is, health insurance is affordable if in order to pay for it one does not to have to sacrifice other benefit(s) that are comparable in importance to the benefits of health coverage. (shrink)

In ‘Parental Virtues: A New Way of Thinking about the Morality of Reproductive Actions’ Rosalind McDougall proposes a virtue-based framework to assess the morality of child selection. Applying the virtue-based account to the selection of children with impairments does not lead, according to McDougall, to an unequivocal answer to the morality of selecting impaired children. In ‘Impairment, Flourishing, and the Moral Nature of Parenthood,’ she also applies the virtue-based account to the discussion of child selection, and claims that couples with (...) an impairment are morally justified in selecting a child with the same impairment. This claim, she maintains, reveals that the flourishing of a child should be understood as requiring environment-specific characteristics. I argue that McDougall's argument begs the question. More importantly, it does not do justice to virtue ethics. I also question to what extent a virtue ethics framework can be successfully applied to discussions about the moral permissibility of reproductive actions. (shrink)

Philip Pettit is the most important contemporany advocate of the republican tradition in political philosophy. He advances a concept of freedom as non-domination, and constrasts it with the liberal conception of freedom as non-interference. He claims that two features distinguish domination from interference: (1) The capacity of interference ( as opposed to actual interference), and (2) the fact that the interference is arbitrary. I shall argue that Pettit´s republicanism is not sufficiently differente from liberalism, certainly not from John Rawls´s liberalism. (...) The only relevant difference between republicanism and liberalism is related to (2): the notion of arbitrariness. Yet this difference makes republicanism an unattractive version of liberalism, insofar as it, paradoxically, allows for republicanism to legitimize a grave form of domination, paternalism, and, in general, domination coming from the state. This problem gets exacerbated by Pettit´s consequentialist framework. (shrink)

El Foro Global de Bioética en Investigación (GFBR por sus siglas en inglés) se reunió el 3 y 4 de noviembre en Buenos Aires, Argentina, con el objetivo de discutir la ética de la investigación con mujeres embarazadas. El GFBR es una plataforma mundial que congrega a actores clave con el objetivo de promover la investigación realizada de manera ética, fortalecer la ética de la investigación en salud, particularmente en países de ingresos bajos y medios, y promover colaboración entre países (...) del norte y del sur.a Los participantes en el GFBR provenientes de Latinoamérica incluyeron a eticistas, investigadores, miembros de comités de ética y representantes de autoridades sanitarias provenientes de Argentina, Brasil, Chile, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Panamá, Perú, Nicaragua y la República Dominicana. Una legítima preocupación por la protección de las mujeres embarazadas y sus embriones o fetos ha llevado a la mayoría de los países de la Región de las Américas a limitar la realización de estudios con mujeres embarazadas exclusivamente a aquellos estudios específicos sobre el embarazo, y a requerir la exclusión sistemática de las mujeres embarazadas o de las mujeres que quedan embarazadas en el curso del estudio. Ciertamente, a lo largo de la historia de la ética de la investigación, se ha creído erróneamente que proteger a una población es sinónimo de excluirla de los estudios. Se sabe ahora que proceder así implica exponer a riesgos mucho mayores a la población que se busca proteger. El embarazo implica cambios fisiológicos sustantivos e impacta profundamente la manera como el cuerpo metaboliza los medicamentos. Sin embargo, por evitar hacer investigación con mujeres embarazadas, no se ha producido la evidencia científica necesaria para tomar decisiones sobre tratamientos e intervenciones preventivas con dosis eficaces y seguras para ellas y sus embriones o fetos. A manera de ilustración, en el 2001 había en los Estados Unidos apenas más de una docena de medicamentos aprobados para uso en el embarazo (1) y en el 2011 la Food and Drug Administration (FDA) aprobó por primera vez en 15 años un medicamento para su uso en el embarazo (2). Como consecuencia de no haber producido la evidencia necesaria, se pone en riesgo la salud de las mujeres embarazadas cada vez que se les da atención médica. Las mujeres embarazadas se enferman y las mujeres enfermas se embarazan, y no se sabe si los medicamentos que se les da son eficaces o siquiera seguros para ellas y sus embriones o fetos. (shrink)

Evidence shows that women have greater difficulty than men in affording health care. But what is it to afford health care? According to the reasonable tradeoff account of affordability, individuals can afford health care if paying for it does not require them to make tradeoffs that are not reasonable—that is, if in order to pay for health care they do not have to sacrifice something as important as having one’s health covered. Unlike alternative accounts of affordability, which are empirically based (...) and needs-based, the reasonable tradeoff account can solve the genuine affordability problems that both men and women experience, and close the gender gap in the affordability of health care. (shrink)

In “Self-Defeating Codes of Medical Ethics and How to Fix Them: Failures in COVID-19 Response and Beyond”, Alex London soundly argues that statements of the core ethical and professio...

Philip Pettit is the most important contemporany advocate of the republican tradition in political philosophy. He advances a concept of freedom as non-domination, and constrasts it with the liberal conception of freedom as non-interference. He claims that two features distinguish domination from interference: The capacity of interference , and the fact that the interference is arbitrary. I shall argue that Pettit´s republicanism is not sufficiently differente from liberalism, certainly not from John Rawls´s liberalism. The only relevant difference between republicanism and (...) liberalism is related to : the notion of arbitrariness. Yet this difference makes republicanism an unattractive version of liberalism, insofar as it, paradoxically, allows for republicanism to legitimize a grave form of domination, paternalism, and, in general, domination coming from the state. This problem gets exacerbated by Pettit´s consequentialist framework. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

Recent evidence confirming that the administration of antiretroviral drugs (ARVs) to HIV-infected persons may effectively reduce their risk of transmission has revived the discussion about priority setting in the fight against HIV/AIDS. The fact that the very same drugs can be used both for treatment purposes and for preventive purposes (Treatment as Prevention) has been seen as paradigm-shifting and taken to spark a new controversy: In a context of scarce resources, should the allocation of ARVs be prioritized based on the (...) goal of providing treatment, or on the goal of preventing the spread of the HIV epidemic? Contributions to this discussion tend to assume that treatment and prevention constitute two divergent goals that entail conflicting priorities. We challenge that assumption on the basis of both conceptual and empirical examination. We argue that, as far as the provision of ARVs to HIV-infected persons is concerned, the goals of treatment and prevention do not entail conflicting priorities; to the contrary, they dictate converging strategies for the optimal allocation of ARVs. In light of the current evidence, the concept of Treatment as Prevention can indeed be seen as paradigm-shifting, yet in a novel way: Rather than extending the tension between the goals of treatment and prevention to the level of drug-allocation, it dissolves this tension by providing a rationale for a unified strategy for allocating ARVs. (shrink)

Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.

In the context of a public health emergency it is imperative to conduct research studies that will produce evidence rapidly while upholding ethical standards. The Ebola and Zika outbreaks highlighted the importance of devising agile processes for ethics review in emergencies, and international research ethics guidelines stress the duty to depart from standard processes for ethics review in emergency circumstances. However, before the COVID-19 pandemic it was not entirely clear what emergency procedures should look like. An additional challenge is that (...) while the same substantive ethical standards apply in emergency and non-emergency settings, deciding what these standards entail in the specific circumstances of a pandemic may be difficult. During the COVID-19 pandemic, challenges included identifying thresholds of social and scientific value, along with duties towards research participants, given the absence of therapeutic options; assessing continually changing risk–benefit profiles of studies, given rapidly emerging new evidence; developing appropriate informed consent processes, given lockdown scenarios; and even addressing the ethics of offering unproven interventions outside research settings. Additional issues raised during epidemics include devising feasible and meaningful community engagement strategies, mechanisms to ensure fairness in the distribution of the benefits that may result from research, and equitable and effective data-sharing plans that will inform pandemic response. Learning from these procedural and substantive challenges encountered in the ethics review of COVID-19 research is important for enhancing ethics preparedness for future emergencies. It can also potentially contribute to improving the ethics review of research in non-emergency circumstances. The seven cases in this chapter highlight ethical issues associated with ethics approval of multi-centre studies in pandemics, the need for careful consideration of the social and scientific value of research and challenges encountered when interventions are being transitioned from research to rollout, and issues that can arise when existing regulations and policies may limit capacities to appropriately adapt research to pandemic contexts. (shrink)

With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...) the disadvantaged; and 3) treating people with equal moral concern. Post-exposure prophylaxis (PEPV) has the most potential to mitigate harm, and so ensuring countries have sufficient supply for PEPV should be the first priority. And historically endemic countries, which face disadvantages that compound potential harms from monkeypox, should be the first recipients of such vaccines. Once sufficient supply is allocated for countries to apply PEPV, global allocation could move on to pre-exposure prophylaxis (PrEP), again prioritizing historically endemic countries first before distribution to the rest of the global community, based on projected number of cases and vulnerability to harm. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...) tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

Este repertorio registra los artículos sobre Platón que se encuentran en la Hemeroteca de la Biblioteca Central de la Pontificia Universidad Católica del Perú. El listado abarca las publicaciones existentes hasta el primer semestre del año 2000.

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...) care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health. (shrink)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...) members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)

This open access casebook addresses complex and important ethical challenges arising when health-related research in conducted in the context of epidemics and pandemics. This book provides contextually-rich real-world case studies illustrating research ethics issues encountered by researchers, ethics reviewers and regulators around the globe during the COVID-19 pandemic. The accompanying commentaries outline relevant conceptual approaches and ethical considerations. These promote understanding and reflection on relevant ethical issues, ethical approaches and competing considerations in a manner supporting thoughtful evaluation of their implications (...) for practice. As such the casebook is relevant to academic and professional audiences with an interest in global health, research ethics, and outbreaks and epidemics. (shrink)

Elizabeth Anker y Bernardette Meyler, profesoras de literatura y de derecho respectivamente, involucradas ambas en los últimos años con el movimiento “derecho y literatura”, editan en 2017 New Directions in Law and Literature.

Nancy Jecker’s essay Nothing to be Ashamed of: Sex Robots for Older Adults with Disabilities 1 presents a provocative application of the capabilities approach. Her ethical argument for providing access to sex robots for older adults with disabilities proceeds in five parts: 1. Older adults frequently suffer disabilities that impair sexual functioning. 2. The ability to function sexually is linked to central human capabilities, including: the ability to generate a personally meaningful life narrative; be physically, mentally and emotionally healthy; experience (...) bodily integrity; feel and express a range of human emotions; affiliate deeply with others; and reflect on and choose a plan for their life. 3. Society should take reasonable steps to support these human capabilities at a minimal threshold as part of a broader duty to respect human dignity. 4. Providing access to sex robots comprises part of reasonable efforts to support the six capabilities at a minimal threshold. 5. Therefore, society ought to make reasonable efforts to ensure access to sex robots for older adults with disabilities that impair sexual functioning. I am sympathetic to this line of reasoning, having proposed a series of legal reforms that would facilitate sexual expression among older adults with cognitive impairments as well.2 3 …. (shrink)

La fenomenología distingue el cuerpo-objeto (Körper) del cuerpo vivido (Leib); se interesa por este último y por el cuerpo que se nos manifiesta en nuestras experiencias y les da expresión. Este cuerpo fenoménico es el punto cero de nuestras vidas, el anclaje de nuestra existencia. La fenomenología de Simone de Beauvoir le aplica la diferencia sexual.Esta contribución continúa la hermenéutica de Beauvoir centrándose en su conocida máxima, “no se nace mujer, se llega a serlo”, teniendo en cuenta que las interpretaciones (...) se dan desde y para determinadas situaciones. La nuestra es el siglo XXI y las investigaciones fenomenológicas y feministas. Dado que la traducción es un modo de interpretación, señalaremos cómo El segundo sexo ha contribuido a comprender el devenir mujer. Para ello, en primer lugar, expondremos nuestra concepción hermenéutica de la traducción. Destacaremos después el “estilo” fenomenológico de Beauvoir y las influencias recíprocas con Merleau-Ponty para abrir la posibilidad de una diferencia sexual sin determinismos. (shrink)

This Article uses age as an entry point for examining how temporal and methodological issues in egalitarianism make substantive equality an unattractive goal for vulnerability theory. Instead, vulnerability theory should adopt a continuous doctrine of sufficiency, which is a better fit with vulnerability theory’s underlying aims and rhetoric. Instead of evaluating what individuals have in relation to others, sufficiency refocuses the inquiry on whether we have enough throughout the lifecourse. In the context of vulnerability theory, enough should be defined as (...) the capability to be resilient as guaranteed by the responsive state. (shrink)

Although US and European research has documented improvement in earnings quality associated with corporate governance characteristics, the situation in Latin America is questionable, given the business environment in which firms operate, which is characterized by controlling family ownership and weak legal protection. The purpose of this study is to examine the relation between the internal mechanisms of Corporate Governance and Earnings Management measured by discretionary accrual. We use a sample of listed Latin American non-financial companies from the period 2006–2009. Our (...) results show how in the Latin American context the role of external directors is limited and that Boards which meet more frequently take a more active position in the monitoring of insiders, so showing a lower use of manipulative practices. In addition, we find a non-linear relation between insider ownership and discretionary accruals, also pointing to the fact that ownership concentration may be a manipulative practices constrictor mechanism only when the ownership of main shareholders is moderate. The findings have important policy implications since this is, to the best of our knowledge, the first study to analyze the relation between the effectiveness of the government and the earnings management behavior. As policy implications, we document how when a country implements controls aimed at reducing corruption, strengthening the rule of law or improving the effectiveness of government, this leads to a reduction in firm earnings management. (shrink)

On Kant's view, the feeling of respect is the mark of moral agency, and is peculiar to us, animals endowed with reason. Unlike any other feeling, respect originates in the contemplation of the moral law, that is, the idea of lawful activity. This idea works as a constraint on our deliberation by discounting the pretenses of our natural desires and demoting our selfish maxims. We experience its workings in the guise of respect. Respect shows that from the agent's subjective perspective, (...) morality is the experience of being bound and necessitated, but also of being free and emancipated from inclinations. (shrink)

On Kant's view, the feeling of respect is the mark of moral agency, and is peculiar to us, animals endowed with reason. Unlike any other feeling, respect originates in the contemplation of the moral law, that is, the idea of lawful activity. This idea works as a constraint on our deliberation by discounting the pretenses of our natural desires and demoting our selfish maxims. We experience its workings in the guise of respect. Respect shows that from the agent's subjective perspective, (...) morality is the experience of being bound and necessitated, but also of being free and emancipated from inclinations.Respect is a feeling that is generated by the agent's reflection on the nature of her own agency. It is not directed to anybody in particular, but to the very idea of rational agency, which is characterized by self-mastery and self-legislation. Contrary to animals, we do not derive our ends from nature, but we are capable of setting ends of our own, by exercising practical reason, that is, by engaging in the activity of law making. (shrink)

Truthmaker says that things, broadly construed, are the ontological grounds of truth and, therefore, that things make truths true. Recently, there have been a number of arguments purporting to show that if one embraces Truthmaker, then one ought to embrace Truthmaker Maximalism—the view that all non-analytic propositions have truthmakers. But then if one embraces Truthmaker, one ought to think that negative existentials have truthmakers. I argue that this is false. I begin by arguing that recent attempts by Ross Cameron and (...) Jonathan Schaffer to provide negative existentials with truthmakers fail. I then argue that the conditional—if one embraces Truthmaker, the one ought to embrace Truthmaker Maximalism—is false by considering worlds where very little, if anything at all, exists. The conclusion is that thinking that negative existentials do not have truthmakers, and therefore rejecting Truthmaker Maximalism, need not worry Truthmaker embracers. (shrink)

As I will use the term, an object is a mereological sum of some things just in case those things compose it simply in virtue of existing. In the first half of this paper, I argue that there are no sums. The key premise for this conclusion relies on a constraint on what, in certain cases, it takes for something to ground, or metaphysically explain, something else. In the second half, I argue that in light of my argument against sums, (...) Universalism, which is perhaps the most widely accepted answer to the Special Composition Question, is false. (shrink)

Comme ailleurs dans le monde, les courants évangéliques et pentecôtistes ont tenté dès les années 1980 de s’imposer dans l’espace public de l’Afrique de l’Ouest. Bien qu’apparus au début du XX e siècle, ce n’est que dans la deuxième moitié du siècle que l’on observe un changement dans l’engagement évangélique vis-à-vis de la société : d’un retrait du monde à une « ouverture vers l’activité politique », marquée par le thème du combat spirituel pour les territoires. En Afrique de l’Ouest, (...) cette nouvelle visibilité dans l’espace public s’est concrétisée par l’élection de présidents évangéliques, comme Matthieu Kérékou au Bénin en 1996, ou Laurent Gbagbo en Côte d’Ivoire en 2000. Mais au sein d’une même société, les relations entre évangélismes et politique peuvent ainsi être multiples. Pour les saisir, il est nécessaire d’adopter différents points de vue, depuis les instances de pouvoir jusqu’aux relations interpersonnelles de la vie quotidienne. (shrink)

As it is presently employed, grounding permits grounding many things from one ground. In this paper, I show why this is a mistake by pushing for a uniqueness principle on grounding. After arguing in favor of this principle, I say something about it and kinds of grounding, discuss a similar principle, and consider its import on a formal feature of grounding, ontology, and ontological simplicity.

Some contemporary philosophers, notably B. Williams and S. Wolf, argue that moral perfection is not just an unsustainable ideal, but also an unreasonable one in that it thwarts and demotes all the various elements that contribute to personal well-being. More importantly, moral perfection seems to imply the denial of an identifiable personal self; hence the paradox of moral perfection. I argue that this alleged paradox arises because of a misunderstanding of the role of moral ideals, of their overridingness, and of (...) the way they relate to well-being. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives also reflect (...) on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)

Background Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units . A quantitative, multicentre, correlational study was conducted among 300 professionals.Results The most crucial ethical decisions made by professionals working in ICU were related to (...) communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments , to withhold treatments and to proceed to terminal sedation . This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses , it was the physicians who more keenly felt the need to proceed to ethical decisions in ICU.Conclusions Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout. (shrink)

Ludwig Wittgenstein’s practical incursions on the domain of art were many and well known. It is worth drawing attention to the design that he did together with Paul Engelmann for his sister Margarethe Stonborough-Wittgenstein’s house and the bust he made for, and was inspired by, the sculptor Michael Drobil. To attribute just an anecdotal character to Wittgenstein’s few artistic projects is a misunderstanding. The Austrian philosopher devoted himself to them with the fervor and rigor that characterize his philosophical writings. He (...) took care of every detail in his sister’s house, which sometimes ended up in difficult changes, although quite minimal (as when he had the ceilings lowered a few centimeters just before .. (shrink)

Research on children’s ability to attribute false mental states to others has focused exclusively on false beliefs. We developed a novel paradigm that focuses instead on another type of false mental state: false perceptions. From approximately 4 years of age, children begin to recognize that their perception of an illusory object can be at odds with its true properties. Our question was whether they also recognize that another individual viewing the object will similarly experience a false perception. We tested 33 (...) preschool children with a task in which distorting lenses caused a small object to appear large and a large object to appear small. To succeed, children needed to recognize that a naive agent would falsely perceive the relative size of the objects and to correctly anticipate the agent’s actions on that basis. Children performed significantly better than chance in our false perception test, and there was a developmental progression in performance from 4 to 5 years of age similar to that seen in standard false belief tests. Our findings demonstrate that preschool children are capable of understanding that other individuals will be perceptually misled by illusory objects and that these false perceptions will influence their actions in predictable ways. (shrink)

Este trabajo pretende comprender la ética como un modo específico de sabiduría, distinguiéndola de otros modos de sabiduría, como son la magia, el mito, la técnica, la religión y la filosofía. A su vez, se establece la importancia que tiene la virtud para el planteamiento de Polo de la ética como carácter propio de este modo de sabiduría. A continuación, se intenta establecer algunas similitudes y diferencias entre la antropología de Polocon la de Zubiri referida a la noción de virtud.

Este artículo estudia la razón de Zambrano desde sus albores como razón mediadora. Su rechazo del sistema va unido a su comienzo en la intuición y a su decurso temporal, que analizamos en relación con Bergson y Husserl. La razón poética va más allá de ese núcleo intuitivo para revelar re-flexivamente incluso lo invisible. Su inmersión en las profundidades, en la pasividad actuante, en las entrañas, en la multiplicidad de los tiempos es paralela a la fenomenología de la génesis merleau-pontiana, (...) a su poiesis carnal e incluso al telos de una razón ampliada al sentir. Ambos filósofos ejercitan su nueva concepción de la filosofía en la existencia. (shrink)

This article explores twelve short narrative films created by women and trans people living with disabilities and embodied differences. Produced through Project Re•Vision, these micro documentaries uncover the cultures and temporalities of bodies of difference by foregrounding themes of multiple histories: body, disability, maternal, medical, and/or scientific histories; and divergent futurities: contradictory, surprising, unpredictable, opaque, and/or generative futures. We engage with Alison Kafer's call to theorize disability futurity by wrestling with the ways in which “the future” is normatively deployed in (...) the service of able-bodiedness and able-mindedness, a deployment used to render bodies of difference as sites of “no future”. By re-storying embodied difference, the storytellers illuminate ongoing processes of remaking their bodily selves in ways that respond to the past and provide possibilities for different futures; these orientations may be configured as “dis-topias” based not on progress, but on new pathways for living, uncovered not through evoking the familiar imaginaries of curing, eliminating, or overcoming disability, but through incorporating experiences of embodied difference into time. These temporalities gesture toward new kinds of futures, giving us glimpses of ways of cripping time, of cripping ways of being/becoming in time, and of radically re-presencing disability in futurity. (shrink)

It is my contention that there is a significant relationship between “Phenomenology of Perception” (Merleau-Ponty) and “The Second Sex” (de Beauvoir). The two authors give great importancc to the lived body (Leib), either from a neutral perspective, either from a perspective feminine. This key concept of the phenomenology allows us to understand the lived experience of women and their possible relationship with feminism. From this corporeal sense we analyze the Merleau-Pontinian redefinition of subjectivity and reason. We emphasize his criticism of (...) reductionism, both epistemological as ontological. We refute certain feminists accusations against Merleau-Ponty. To do this, we study all his work in search of traces of women, we place them in context, while we study his own hermeneutics of psychoanalysis in order to highlight the contribution of it to the deconstruction of stereotypes about femininity. We conclude by showing the main keys of this phenomenology for· the current feminist Philosophy. (shrink)

En este trabajo caracterizamos la filosofia de M. Merleau-Ponty como una fenomenología de la expresión ontológica, por considerar que reflexiona sobre algunos impensados de Husserl y los prolonga en una nueva ontología contribuyendo así, una vez más, a superar los dualismos heredados, en este caso, el que se produce entre fenomenología y ontología. Aunque haremos un recorrido por toda la obra merleau-pontiana, para pensar el sentir nos centraremos en la última, en la que el cuerpo vivido, pieza clave de la (...) rehabilitación ontológica de lo sensible, interacciona entre lo visible y lo invisible y la percepción se redefine como proceso que ocurre entre mi carne y la carne del mundo. Así veremos cómo Merleau-Ponty desarrolla la génesis y la síntesis pasiva explicitando el problema de· la estética transcendental, implícita en Husserl. Ésta se inicia con la reflexividad corporal y culmina en la reversibilidad siempre inminente de la carne. La ·fenomenología describe la experiencia originaria de ese sentir desde dentro de su propia evidencia. (shrink)