Supra-Bayesianism is the Bayesian response to learning the opinions of others. Probability pooling constitutes an alternative response. One natural question is whether there are cases where probability pooling gives the supra-Bayesian result. This has been called the problem of Bayes-compatibility for pooling functions. It is known that in a common prior setting, under standard assumptions, linear pooling cannot be nontrivially Bayes-compatible. We show by contrast that geometric pooling can be nontrivially Bayes-compatible. Indeed, we show that, under certain assumptions, geometric and (...) Bayes-compatible pooling are equivalent. Granting supra-Bayesianism its usual normative status, one upshot of our study is thus that, in a certain class of epistemic contexts, geometric pooling enjoys a normative advantage over linear pooling as a social learning mechanism. We discuss the philosophical ramifications of this advantage, which we show to be robust to variations in our statement of the Bayes-compatibility problem. (shrink)

The question of how the probabilistic opinions of different individuals should be aggregated to form a group opinion is controversial. But one assumption seems to be pretty much common ground: for a group of Bayesians, the representation of group opinion should itself be a unique probability distribution, 410–414, [45]; Bordley Management Science, 28, 1137–1148, [5]; Genest et al. The Annals of Statistics, 487–501, [21]; Genest and Zidek Statistical Science, 114–135, [23]; Mongin Journal of Economic Theory, 66, 313–351, [46]; Clemen and (...) Winkler Risk Analysis, 19, 187–203, [7]; Dietrich and List [14]; Herzberg Theory and Decision, 1–19, [28]). We argue that this assumption is not always in order. We show how to extend the canonical mathematical framework for pooling to cover pooling with imprecise probabilities by employing set-valued pooling functions and generalizing common pooling axioms accordingly. As a proof of concept, we then show that one IP construction satisfies a number of central pooling axioms that are not jointly satisfied by any of the standard pooling recipes on pain of triviality. Following Levi, 3–11, [39]), we also argue that IP models admit of a much better philosophical motivation as a model of rational consensus. (shrink)

In many assessment problems—aptitude testing, hiring decisions, appraisals of the risk of recidivism, evaluation of the credibility of testimonial sources, and so on—the fair treatment of different groups of individuals is an important goal. But individuals can be legitimately grouped in many different ways. Using a framework and fairness constraints explored in research on algorithmic fairness, I show that eliminating certain forms of bias across groups for one way of classifying individuals can make it impossible to eliminate such bias across (...) groups for another way of dividing people up. And this point generalizes if we require merely that assessments be approximately bias-free. Moreover, even if the fairness constraints are satisfied for some given partitions of the population, the constraints can fail for the coarsest common refinement, that is, the partition generated by taking intersections of the elements of these coarser partitions. This shows that these prominent fairness constraints admit the possibility of forms of intersectional bias. (shrink)

For two ideally rational agents, does learning a finite amount of shared evidence necessitate agreement? No. But does it at least guard against belief polarization, the case in which their opinions get further apart? No. OK, but are rational agents guaranteed to avoid polarization if they have access to an infinite, increasing stream of shared evidence? No.

There is a theorem that shows that it is impossible for an algorithm to jointly satisfy the statistical fairness criteria of Calibration and Equalised Odds non-trivially. But what about the recently advocated alternative to Calibration, Base Rate Tracking? Here, we show that Base Rate Tracking is strictly weaker than Calibration, and then take up the question of whether it is possible to jointly satisfy Base Rate Tracking and Equalised Odds in non-trivial scenarios. We show that it is not, thereby establishing (...) an even more general impossibility theorem. (shrink)

I provide a characterization of weakly pseudo-rationalizable choice functions---that is, choice functions rationalizable by a set of acyclic relations---in terms of hyper-relations satisfying certain properties. For those hyper-relations Nehring calls extended preference relations, the central characterizing condition is weaker than (hyper-relation) transitivity but stronger than (hyper-relation) acyclicity. Furthermore, the relevant type of hyper-relation can be represented as the intersection of a certain class of its extensions. These results generalize known, analogous results for path independent choice functions.

Our aim here is to present a result that connects some approaches to justifying countable additivity. This result allows us to better understand the force of a recent argument for countable additivity due to Easwaran. We have two main points. First, Easwaran’s argument in favour of countable additivity should have little persuasive force on those permissive probabilists who have already made their peace with violations of conglomerability. As our result shows, Easwaran’s main premiss – the comparative principle – is strictly (...) stronger than conglomerability. Second, with the connections between the comparative principle and other probabilistic concepts clearly in view, we point out that opponents of countable additivity can still make a case that countable additivity is an arbitrary stopping point between finite and full additivity. (shrink)

Recent impossibility theorems for fair risk assessment extend to the domain of epistemic justice. We translate the relevant model, demonstrating that the problems of fair risk assessment and just credibility assessment are structurally the same. We motivate the fairness criteria involved in the theorems as also being appropriate in the setting of testimonial justice. Any account of testimonial justice that implies the fairness/justice criteria must be abandoned, on pain of triviality.

This paper generalizes rationalizability of a choice function by a single acyclic binary relation to rationalizability by a set of such relations. Rather than selecting those options in a menu that are maximal with respect to a single binary relation, a weakly pseudo-rationalizable choice function selects those options that are maximal with respect to at least one binary relation in a given set. I characterize the class of weakly pseudo-rationalizable choice functions in terms of simple functional properties. This result also (...) generalizes Aizerman and Malishevski's characterization of pseudo-rationalizable choice functions, that is, choice functions rationalizable by a set of total orders. (shrink)

Merging of opinions results underwrite Bayesian rejoinders to complaints about the subjective nature of personal probability. Such results establish that sufficiently similar priors achieve consensus in the long run when fed the same increasing stream of evidence. Initial subjectivity, the line goes, is of mere transient significance, giving way to intersubjective agreement eventually. Here, we establish a merging result for sets of probability measures that are updated by Jeffrey conditioning. This generalizes a number of different merging results in the literature. (...) We also show that such sets converge to a shared, maximally informed opinion. Convergence to a maximally informed opinion is a (weak) Jeffrey conditioning analogue of Bayesian “convergence to the truth” for conditional probabilities. Finally, we demonstrate the philosophical significance of our study by detailing applications to the topics of dynamic coherence, imprecise probabilities, and probabilistic opinion pooling. (shrink)

This essay has two aims. The first is to correct an increasingly popular way of misunderstanding Belot's Orgulity Argument. The Orgulity Argument charges Bayesianism with defect as a normative epistemology. For concreteness, our argument focuses on Cisewski et al.'s recent rejoinder to Belot. The conditions that underwrite their version of the argument are too strong and Belot does not endorse them on our reading. A more compelling version of the Orgulity Argument than Cisewski et al. present is available, however---a point (...) that we make by drawing an analogy with de Finetti's argument against mandating countable additivity. Having presented the best version of the Orgulity Argument, our second aim is to develop a reply to it. We extend Elga's idea of appealing to finitely additive probability to show that the challenge posed by the Orgulity Argument can be met. (shrink)

We explore which types of probabilistic updating commute with convex IP pooling. Positive results are stated for Bayesian conditionalization, imaging, and a certain parameterization of Jeffrey conditioning. This last observation is obtained with the help of a slight generalization of a characterization of externally Bayesian pooling operators due to Wagner :336–345, 2009). These results strengthen the case that pooling should go by imprecise probabilities since no precise pooling method is as versatile.

We provide counterexamples to some purported characterizations of dilation due to Pedersen and Wheeler :1305–1342, 2014, ISIPTA ’15: Proceedings of the 9th international symposium on imprecise probability: theories and applications, 2015).

An aspect of Peirce’s thought that may still be underappreciated is his resistance to what Levi calls _pedigree epistemology_, to the idea that a central focus in epistemology should be the justification of current beliefs. Somewhat more widely appreciated is his rejection of the subjective view of probability. We argue that Peirce’s criticisms of subjectivism, to the extent they grant such a conception of probability is viable at all, revert back to pedigree epistemology. A thoroughgoing rejection of pedigree in the (...) context of probabilistic epistemology, however, _does_ challenge prominent subjectivist responses to the problem of the priors. (shrink)

In the face of an impossibility result, some assumption must be relaxed. The Mere Addition Paradox is an impossibility result in population ethics. Here, I explore substantially weakening the decision-theoretic assumptions involved. The central finding is that the Mere Addition Paradox persists even in the general framework of choice functions when we assume Path Independence as a minimal decision-theoretic constraint. Choice functions can be thought of either as generalizing the standard axiological assumption of a binary “betterness” relation, or as providing (...) a general framework for a normative (rather than axiological) theory of population ethics. Path Independence, a weaker assumption than typically (implicitly) made in population ethics, expresses the idea that, in making a choice from a set of alternatives, the order in which options are assessed or considered is ethically arbitrary and should not affect the final choice. Since the result establishes a conflict between the relevant ethical principles and even very weak decision-theoretic principles, we have more reason to doubt the ethical principles. (shrink)

Epistemic states of uncertainty play important roles in ethical and political theorizing. Theories that appeal to a “veil of ignorance,” for example, analyze fairness or impartiality in terms of certain states of ignorance. It is important, then, to scrutinize proposed conceptions of ignorance and explore promising alternatives in such contexts. Here, I study Lerner’s probabilistic egalitarian theorem in the setting of imprecise probabilities. Lerner’s theorem assumes that a social planner tasked with distributing income to individuals in a population is “completely (...) ignorant” about which utility functions belong to which individuals. Lerner models this ignorance with a certain uniform probability distribution, and shows that, under certain further assumptions, income should be equally distributed. Much of the criticism of the relevance of Lerner’s result centers on the representation of ignorance involved. Imprecise probabilities provide a general framework for reasoning about various forms of uncertainty including, in particular, ignorance. To what extent can Lerner’s conclusion be maintained in this setting? (shrink)

Bayesians often appeal to “merging of opinions” to rebut charges of excessive subjectivity. But what happens in the short run is often of greater interest than what happens in the limit. Seidenfeld and coauthors use this observation as motivation for investigating the counterintuitive short run phenomenon of dilation, since, they allege, dilation is “the opposite” of asymptotic merging of opinions. The measure of uncertainty relevant for dilation, however, is not the one relevant for merging of opinions. We explicitly investigate the (...) short run behavior of the metric relevant for merging, and show that dilation is independent of the opposite of merging. (shrink)

This paper studies a generalization of rational choice theory. I briefly review the motivations that Helzner gives for his conditional choice construction . Then, I focus on the important class of conditional choice functions with vacuous second tiers. This class is interesting for both formal and philosophical reasons. I argue that this class makes explicit one of conditional choice’s normative motivations in terms of an account of neutrality advocated within a certain tradition in decision theory. The observations recorded—several of which (...) are generalizations of central results in the standard theory of rational choice—are intended to provide further insight into how conditional choice generalizes the standard account and are offered as additional evidence of the fruitfulness of the conditional choice framework. (shrink)

Analysis (2021), https://doi.org/10.1093/analys/anab012.

Given the role consensus is supposed to play in the social aspects of inquiry and deliberation, it is important that we may always identify a consensus as the basis of joint inquiry and deliberation. However, it turns out that if we think of an agent revising her beliefs to reach a consensus, then, on the received view of belief revision, AGM belief revision theory, certain simple and compelling consensus positions are not always available.

Photo by Hush Naidoo Jade Photography on Unsplash INTRODUCTION In this collection of narratives, the authors describe their own experiences with and reflections on healthcare worker vaccine hesitancy. The narratives explore each author’s engagement with different communities experiencing vaccine hesitancy, touching on reasons for hesitancy, proposed solutions, and legal aspects. Author’s names appear above their narratives. l. Johanna T. Crane Vaccine hesitancy, defined as “a delay of acceptance or refusal of vaccination despite the availability of vaccination services,”[1] is a worldwide (...) but locally shaped phenomenon that pre-dates the COVID-19 pandemic.[2] Contrary to some portrayals, vaccine hesitancy is not the same as the more absolute antivaccination stance, or what some call “anti-vax.” Many people who are hesitant are not ideologically opposed to vaccines. Hesitancy is also sometimes framed as anti-science, yet reluctance to vaccinate is often about managing risk, trustworthiness, and doubt in the context of uncertainty; it represents an effort to “talk back to science” about unaddressed needs and concerns.[3] In the US, the newness of the vaccines, the unprecedented speed at which they were developed, and their remaining under emergency use authorization at first complicated public confidence. Political polarization and racial and social inequality shape vaccine acceptance and public distrust as well. While vaccine acceptance has increased in the months since the vaccines first became available, many eligible individuals have not yet been vaccinated, including a significant number of healthcare workers.[4] Vaccine hesitancy among healthcare workers may seem surprising, especially given their frontline experience – I confess that it surprised me at first. But when I began interviewing health care workers for a study on COVID vaccine roll-out at community health centers, I learned to take a more complex view. Although the study was focused on patient vaccine access,[5] many of the frontline health care workers we spoke with also described hesitancy among some of their colleagues. From these conversations, I learned that these “healthcare heroes” are also regular people and members of communities. Their concerns about COVID vaccination often reflect the prevailing concerns advanced in their communities, such as worries about vaccine side effects and safety. Like other workers, some fear missing work and losing income, as not all healthcare employers offer paid time off for vaccination or recovery. [6] For some healthcare workers of color, the protection offered by the vaccine sits in tension with both current and historical experiences of medical abuse and neglect. Some interviewees, fully vaccinated themselves, rejected the framework of “hesitancy” entirely, arguing that Black and Brown reluctance to be vaccinated first should be understood through the lens of “self-protection”. Due to the nature of their work, healthcare workers have faced great social pressure to vaccinate and vaccinate first. This is understandable, given that vaccination against COVID-19 protects not only workers themselves but aligns with the ethical duty to prevent harm to patients by reducing the risk of transmission in healthcare settings. When the FDA approved COVID-19 vaccines under emergency use authorization in December 2020, many healthcare workers were extremely grateful to be designated “1a” – the first group prioritized to receive the shots.[7] For many bioethicists, prioritization of healthcare workers represented a recognition of the extreme risks that many front-line workers had endured since the onset of the pandemic, including critical shortages in PPE. But it is important to remember that for some workers, going first may have felt like serving as guinea pigs for new vaccines that had yet to be granted full FDA approval. For these individuals, the expectation that they would vaccinate first may have felt like an additional risk rather than a reward. Healthcare workers who are hesitant to vaccinate may feel ashamed or be subject to shaming by others;[8] this may make it difficult to discuss their concerns in the workplace. Throughout the pandemic, healthcare workers have been lauded as “heroes”, and some healthcare employers have promoted vaccination among their workforce as a “heroic” action. This messaging implies that waiting to vaccinate is shameful or cowardly and is echoed in opinion pieces and op-eds describing unvaccinated people as “selfish” or “free riders.”[9] By fostering the proper dialogue, we can respond respectfully to hesitancy among healthcare workers while still working towards the goal of increased vaccination. We in the bioethics and medical community should be willing to listen to our colleagues’ concerns with respect. Top-down approaches aimed at “correcting” hesitancy cannot address the more fundamental issues of trust that are often at stake. Instead, there must be dialogue over time. Conversations with a trusted healthcare provider have a crucial role.[10] Blaming and shaming rhetoric, whether explicit or implicit, gets us nowhere – in fact, it likely moves us backward by likely exacerbating any existing distrust or resentment that workers may hold toward their employers.[11] Lastly, the onus of trust must be with institutions, not individuals. There is a lot of talk about getting communities of color, and Black people, particularly, to "trust" healthcare institutions and the COVID vaccines. This racializes trust and puts the burden on harmed communities rather than on institutions acting in trustworthy ways.[12] Dialogue, respect, and trustworthiness must guide us even in the new era of workplace mandates. Mandates make these strategies even more important as we look toward an uncertain future. As Heidi Larson, founder of the Vaccine Confidence Project, recently said, “We should not forget that we are making people's future history now. Are people going to remember that they were treated respectfully and engaged?”[13] ll. Kara Simpson Since the release of the vaccine for COVID-19 in late 2020, there have been robust discussions within the medical community, the media, and political arenas about vaccine hesitancy among healthcare workers. The public became aware that healthcare workers, the first group to become eligible for the vaccine, were not rushing to “take the shot.” Many people’s opinions were aligned by race, ethnicity, socioeconomic status, and political affiliation. People of color were one of the first groups to be labeled vaccine hesitant as our experiences of distrust of the medical community and the politicization of the vaccine explained the low turnout.[14] It was not uncommon to hear, “this vaccine just came out; let’s wait and see if there are side effects.” Interestingly, many people in the healthcare community and in the public did not understand why healthcare workers of color remained hesitant. Trust is a vital component of any viable relationship, especially in the clinical realm. To have successful health outcomes, it is essential for clinicians to build trusting relationships with their patients and peers. Many people of color are distrustful towards the medical institution due to the years of systemic racism and abuses that they have experienced, witnessed, or learned about. Healthcare workers of color are not excluded from the experiences of their communities outside of work. In fact, I assert that healthcare of color may have an additional burden of hesitation because of their lived experiences of distrust in receiving care and inequality within their professional environment. These dual traumas can work in tandem to strengthen hesitancy. I assert that building trusting clinical relationships will address hesitancy over time. Currently, many healthcare workers are worried about vaccine mandates. For a group of people that have experienced intergenerational enslavement and marginalization, mandates feel coercive and serve as a reminder of how “lesser” bodies are considered unworthy of voice, fundamental human rights, independent decision making. To call the vaccine mandate paternalistic would be an understatement. An unintended result of vaccine mandates will be the reinforcement of hesitancy and distrust of the medical institution as trust and coercion cannot coexist. This mandate will give more power to the conspiracy theories and harm those who already do not seek or receive adequate health care because of systemic inequalities. Furthermore, mandates can also dissuade people of color from becoming healthcare workers, and others may leave the field. In essence, vaccine hesitancy is a symptom of a much larger problem: the distrust of the medical establishment. As bioethicists, our mission should be to support interventions that foster “trustworthiness” of the institutions rather than those that cause trauma. Several organizations have proposed mask mandates and weekly testing as a measure to protect the population at large and still respect the autonomy of the unvaccinated.[15] lll. Jennifer Breznay I work in a very large community teaching hospital in Brooklyn, and we were extremely hard hit by COVID in March 2020. I worked on inpatient medical units and witnessed a lot of suffering. And after nine months of fear and despair about COVID’s toll, I felt tremendous frustration in December when I heard that many healthcare workers would reject the vaccine. As the co-chair of the Bioethics Committee, I drafted a statement recommending vaccination for all employees. When the draft was revised and approved by the Bioethics Committee, I began to discuss it with employees, and I appreciated different perspectives I had not heard before. In the end, rather than releasing the statement, we directed our efforts at creating a dialogue. I also volunteer at a not-for-profit which operates seven early childhood education centers in Northern Brooklyn. The Executive Director invited me to collaborate on strategies to encourage staff vaccination, and we decided to offer a Zoom conference to 20 members of the staff. I was extremely nervous about how the audience would perceive me, a white doctor whom they did not know. I felt awkward about coming to them with an agenda. And there was also the question of whether I was an appropriate messenger compared to a person of color. Yet, I felt like I shouldn't back away from this. So, I chose to simply disclose my discomfort at the beginning of the Zoom. I said, “Thanks for having me. You know, as a white physician, I understand you might have concerns about trusting what I say. Four hundred years of inequity and abuse by the healthcare system can create a lot of mistrust, but I’m here to try to answer your questions.” Ultimately the Executive Director reported that the Zoom was successful in stimulating a lot of conversation among the staff about the vaccine. I think the critical piece is the intimate but open conversation, where you can elicit values. lV. Ashley L. Stewart In the rural areas of our state, healthcare institutions are inextricably tied to their communities. Rural hospitals hire from, serve, and function in the community where they are located. Successful implementation of a vaccine roll-out in such rural areas requires explicit recognition of the role and influence of the community. After identifying issues common to the area, rural institutions can address them. Even when rural institutions find that healthcare worker concerns seem to be unique or personal, they are often related to the larger concerns of the community.[16] Community-based increased vaccine hesitancy may coincide with an underlying issue, such as lack of information rather than principled or experience-based resistance.[17] When the vaccines became available, rural vaccination coordinators encountered a wealth of misinformation that left many people initially undecided. Compounding this lack of information, workers expressed a sense of fear about the professional consequences of voicing concerns, especially in tight-knit communities. Many workers expressed concern about being judged merely for sharing their questions or decisions.[18] They also felt that saying or doing something to promote the value of vaccination might change their relationship with members of the community where they live and work.[19] As there was a fear of engaging in productive conversations, it was difficult for them to find valuable information, and the lack of information discouraged them from being vaccinated. Vaccine coordinators wanted to get information to the entire community based on the most current research and release unbiased, consistent, and timely information from sources all people in the community could trust, including from multiple sources at once. Communication must focus on answering many types of questions, which must often be done in private or anonymously. Where poorly supported or incorrect information is widely available, sharing objective information is crucial to turning the tide of distrust. If the healthcare community dismisses concerns or assumes that answering questions based on misinformation is a waste of time, the community-based institutions will further the distrust. Some may feel that vaccine coordinators should not address misinformation directly, yet avoidance has been widely unsuccessful.[20] Being respectful and non-judgmental in answering questions posed by people who do not know what is true can be hard, but in rural communities, answering completely and honestly without judgment is a critical component of any effort to inform people. Telling people to get vaccinated “for the greater good” can sound the same as being told not to get a vaccine because it is “bad” if both sources of information fail to back up their claims. Ultimately rural institutions are respected because they are a resource to their communities, a priority we must preserve. It is also critical to treat everyone respectfully regardless of vaccine status.[21] People may perceive mandates, divisive policies, or disrespectful treatment of people based on vaccination status as discriminatory or coercive, weakening the appeal of vaccination. Such practices may make people less trusting and more anchored to their position as they come to see vaccination proponents as untrustworthy or authoritarian. We must work to maintain respect for human autonomy. Using unethical means to achieve even a just end will not lead to a “greater good” but rather to the perception that people in positions of authority would achieve a result “by any means necessary.” V. David N. Hoffman The central moral quandary that arises whenever vaccine hesitancy among healthcare workers is discussed is whether workers who refuse to get vaccinated should or could be fired. We should clarify that we are applying a definition of mandate in the employment context for private employers, the violation of which results in loss of employment. Government-controlled provider organizations are just now weighing in on this topic and are generally pursuing strategies that impose periodic, usually weekly, testing requirements for those workers who decline to get vaccinated. In the private sector, employers can require their employees to do a great many things as a condition of employment, and one of them is to get vaccinated against COVID -19. In the most prominent case to date, just such a mandate gave rise to a lawsuit in Texas involving Houston Methodist Hospital. In that case, 170 employees asserted that an employer should not be allowed to force them to get vaccinated. The judge held that, while no employer can force an employee to get vaccinated, no employer is obligated to continue the employment of any employee who declines to follow rules established by that employer, including the obligation to get vaccinated.[22] In Texas, what the judge said is you are not being forced to get vaccinated, but your employer is allowed to set limits and conditions on employment, including vaccination. Employees do not have an obligation to get vaccinated, but they also have no right to their jobs. That is because of a widely misunderstood legal concept: “employment at will.” Employment at will sounds like a rule that employees can do what they want at work, but in fact, employment at will means only that you can quit your job whenever you want. At the same time, your employer can fire you at any time, for any reason or no reason, unless the reason is a pretext and involves one of the protected statuses. Generally, any employers, including hospitals, can decide that if someone is not willing to get a vaccination, or if they are not willing to complete sexual harassment training or participate in the hospital’s infection control program, that is the employee’s right, but it will mean that an employer can similarly decline to continue providing employment. The evolution of this hesitancy discussion will be influenced by the narrower debate playing out in the court of public opinion, and the courts of law, over the enforceability of New York’s recently enacted vaccine mandate. Regardless of whether that mandate survives, with or without medical and religious exemptions, healthcare employers will be left with a profound ethical dilemma. At the end of all the litigation, if there is a religious exemption, employers will always be burdened with the responsibility to determine whether an individual employee has asserted a genuine and sincere religious objection to vaccination and whether the employer is able to provide an accommodation that is safe and effective in protecting the interests of co-workers and patients. The anticipated federal mandate, which reportedly will have a test/mask alternative, will only make this ethical task more challenging. This leads to the final point in this analysis, which is that while private employers, including hospitals, can deprive an individual of their employment if those individuals refuse to get vaccinated, just because an employer can do so does not mean it should do so.[23] - [1] MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33:4161-4164. doi:10.1016/j.vaccine.2015.04.036 [2] Larson HJ, de Figueiredo A, Xiahong Z, et al. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine. 2016;12:295-301. doi:10.1016/j.ebiom.2016.08.042 [3] Larson H. Stuck: How Vaccine Rumors Start - and Why They Don’t Go Away. Oxford University Press; 2020; Benjamin R. Informed Refusal: Toward a Justice-based Bioethics. Sci Technol Hum Values. 2016;41:967-990. doi:10.1177/0162243916656059 [4] Deepa Shivaram, In The Fight Against COVID, Health Workers Aren't Immune To Vaccine Misinformation September 18, 2021. NPR Special Series: The Coronavirus. https://www.npr.org/2021/09/18/1037975289/unvaccinated-covid-19-vaccine-refuse-nurses-heath-care-wor kers [5] Crane JT, Pacia D, Fabi R, Neuhaus C, and Berlinger N. Advancing Covid vaccination equity at Federally Qualified Health Centers: A rapid qualitative review. Accepted and awaiting publication at JGIM. [6] Ashley Kirzinger. “KFF/The Washington Post Frontline Health Care Workers Survey - Vaccine Intentions.” KFF, 22 Apr. 2021, https://www.kff.org/report-section/kff-washington-post-frontline-health-care-workers-survey-vaccine- intentions/. [7] Johanna Crane, Samuel Reis-Dennis and Megan Applewhite. “Prioritizing the ‘1a’: Ethically Allocating Scarce Covid Vaccines to Health Care Workers.” The Hastings Center, 21 Dec. 2020, https://www.thehastingscenter.org/prioritizing-the-1a-ethically-allocating-covid-vaccines-to-health- care-workers/. [8] “'I'm Not an Anti-Vaxxer, but...' US Health Workers' Vaccine Hesitancy Raises Alarm.” The Guardian, Guardian News and Media, 10 Jan. 2021, https://www.theguardian.com/world/2021/jan/10/coronavirus-covid-19-vaccine-hesitancy-us-health-worke rs. [9] Gerson M. If you are healthy and refuse to take the vaccine, you are a free-rider. Washington Post. April 15, 2021. [10] Crane JT, Pacia D, Fabi R, Neuhaus C, and Berlinger N. Advancing Covid vaccination equity at Federally Qualified Health Centers: A rapid qualitative review. Accepted and awaiting publication at JGIM. [11] Larson H. Stuck : How Vaccine Rumors Start - and Why They Don’t Go Away. Oxford University Press; 2020. [12] Benjamin R. Race for Cures: Rethinking the Racial Logics of ‘Trust’ in Biomedicine. Sociology Compass. 2014;8:755-769. doi:10.1111/soc4.12167; Warren RC, Forrow L, David Augustin Hodge S, Truog RD. Trustworthiness before Trust — Covid-19 Vaccine Trials and the Black Community. N Engl J Med. Published online October 16, 2020. doi:10.1056/NEJMp2030033 [13] Offri D. Heidi Larson, Vaccine Anthropologist. New Yorker. Published online June 12, 2021. Accessed August 11, 2021. https://www.newyorker.com/science/annals-of-medicine/heidi-larson-vaccine-anthropologist [14] Razai M S, Osama T, McKechnie D G J, Majeed A. Covid-19 Vaccine Hesitancy Among Ethnic Minority Groups. BMJ 2021; 372 :n513 doi:10.1136/bmj.n513 [15] Dasgupta, Sharoda, et al. “Differences in Rapid Increases in County-Level COVID-19 Incidence by Implementation of Statewide Closures and Mask Mandates — United States, June 1–September 30, 2020.” Annals of Epidemiology, vol. 57, Sept. 2021, pp. 46–53., https://doi.org/10.1016/j.annepidem.2021.02.006. [16] Do, Tuong Vi C et al. “COVID-19 Vaccine Acceptance Among Rural Appalachian Healthcare Workers : A Cross-Sectional Study.” Cureus vol. 13,8 e16842. 2 Aug. 2021, doi:10.7759/cureus.16842; Danabal, K.G.M., Magesh, S.S., Saravanan, S. et al. Attitude towards COVID 19 vaccines and vaccine hesitancy in urban and rural communities in Tamil Nadu, India – a community-based survey. BMC Health Serv Res 21, 994. https://doi.org/10.1186/s12913-021-07037-4 [17] Scott C. Ratzan MD, MPA, MA, Lawrence O. Gostin JD, Najmedin Meshkati PhD, CPE, Kenneth Rabin PhD & Ruth M. Parker MD COVID-19: An Urgent Call for Coordinated, Trusted Sources to Tell Everyone What They Need to Know and Do, Journal of Health Communication, 25:10, 747-749, DOI: 10.1080/10810730.2020.1894015 [18] Huang, Pien. “Some Health Care Workers Are Wary of Getting COVID-19 Vaccines.” NPR, NPR, 1 Dec. 2020, https://www.npr.org/sections/health-shots/2020/12/01/940158684/some-health-care-workers-are-wary-of- getting-covid-19-vaccines. Portnoy, Jenna. “Several Hundred Virginia Health-Care Workers Have Been Suspended or Fired over Coronavirus Vaccine Mandates.” The Washington Post, WP Company, 4 Oct. 2021, https://www.washingtonpost.com/local/covid-vaccine-mandate-hospitals-virginia/2021/10/01/b7976d16-21 ff-11ec-8200-5e3fd4c49f5e_story.html. [19] Jennifer A. Lueck & Alaina Spiers Which Beliefs Predict Intention to Get Vaccinated against COVID-19? A Mixed-Methods Reasoned Action Approach Applied to Health Communication, Journal of Health Communication, 25:10, 790-798, DOI: 10.1080/10810730.2020.1865488 [20] Lockyer, Bridget, et al. “Understanding Covid-19 Misinformation and Vaccine Hesitancy in Context: Findings from a Qualitative Study Involving Citizens in Bradford, UK.” Health Expectations, vol. 24, no. 4, 4 May 2021, pp. 1158–1167., https://doi.org/10.1101/2020.12.22.20248259. Scott C. Ratzan & Ruth M. Parker Vaccine Literacy—Helping Everyone Decide to Accept Vaccination, Journal of Health Communication, 25:10, 750-752, DOI: 10.1080/10810730.2021.1875083. [21] Zimmerman, Anne. Columbia Academic Commons, 2020, Toward a Civilized Vaccination Discussion: Abandoning the False Assumption That Scientific Goals Are Shared by All, https://academiccommons.columbia.edu/doi/10.7916/d8-rzh0-1f73. [22] Bridges, et al v. Houston Methodist Hospital et al, https://docs.justia.com/cases/federal/districtcourts/texas/txsdce/4:2021cv01774/1830373/18 [23] David N. Hoffman, “Vaccine Mandates for Health Care Workers Raise Several Ethical Dilemmas,” Hasting Center Bioethics Forum. August 2021. https://www.thehastingscenter.org/vaccine-mandates-for-health-care-workers-raise-several-ethical-dil emmas/. (shrink)

Abstract Employing an extended case method ethnography (Burawoy 1998), the researcher joined five new members forming a spiritualist's group under the leadership of an experienced advocate. Over a period of eighteen months, the researcher attended all the group's activities and events. Data were collected to reflexively interrogate the process theory of conversion proposed by Lewis Rambo (1993). The data revealed conversion to be a multifaceted and dynamic process of cognitive change, mediated by structural, and contextual forces. The results provide a (...) reconceptualization of Rambo's theory, presenting a theoretical expansion of the model emphasizing its mechanisms of action. The paper details the composition of the “Interaction-Commitment” mechanism, operationalized within four submechanisms emanating from Rambo's roles, rituals, rhetoric, and relationships. This longitudinal study shows that most of the hard work toward conversion occurs before any formal interaction with a conversion advocate. Conversion operates most effectively under conditions of cognitive economy wherein the belief path follows a path of least cognitive expenditure. (shrink)

© 2016 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.Bacteria of the SAR11 clade constitute up to one half of all microbial cells in the oxygen-rich surface ocean. SAR11 bacteria are also abundant in oxygen minimum zones, where oxygen falls below detection and anaerobic microbes have vital roles in converting bioavailable nitrogen to N 2 gas. Anaerobic metabolism has not yet been observed in SAR11, and it remains unknown how these bacteria contribute to OMZ biogeochemical cycling. Here, genomic (...) analysis of single cells from the world's largest OMZ revealed previously uncharacterized SAR11 lineages with adaptations for life without oxygen, including genes for respiratory nitrate reductases. SAR11 nar genes were experimentally verified to encode proteins catalysing the nitrite-producing first step of denitrification and constituted ∼40% of OMZ nar transcripts, with transcription peaking in the anoxic zone of maximum nitrate reduction activity. These results link SAR11 to pathways of ocean nitrogen loss, redefining the ecological niche of Earth's most abundant organismal group. (shrink)

We first consider the entailment logic MC, based on meaning containment, which contains neither the Law of Excluded Middle (LEM) nor the Disjunctive Syllogism (DS). We then argue that the DS may be assumed at least on a similar basis as the assumption of the LEM, which is then justified over a finite domain or for a recursive property over an infinite domain. In the latter case, use is made of Mathematical Induction. We then show that an instance of the (...) LEM is intrumental in the proof of Cantor's Theorem, and we then argue that this is based on a more general form than can be reasonably justified. We briefly consider the impact of our approach on arithmetic and naive set theory, and compare it with intuitionist mathematics and briefly with recursive mathematics. Our "Four Basic Logical Issues" paper would provide useful background, the current paper being an application of the some of the ideas in it. (shrink)

Leadership has been shown to be a fundamental factor influencing the performance of sport teams. Within these teams, leadership can be provided by coaches, formal athlete leaders, such as team captains, and other ‘informal’ athlete leaders. The role of the athlete leader in a team, either formal or informal, has been consistently reported over the last 10 years to have a significant impact upon a teams’ functioning and effectiveness, as well as teammates’ general health and mental wellbeing. As such, cultivating (...) the provision of this leadership within a team has emerged as an important focus for managers, coaches, sport psychologists and scholars alike. While the recognition of the importance of athlete leadership is well established, there has been a lag in the development of systematic approaches to enhance and develop the leadership skills and capabilities of the athletes within sport teams. As a result, this paper seeks to review contemporary examples and current understanding of approaches to athlete leadership development. The paper will also highlight future areas for research and applied practice development. (shrink)

Animal and plant species exhibit an astonishing diversity of sexual systems, including environmental and genetic determinants of sex, with the latter including genetic material in the mitochondrial genome. In several hermaphroditic plants for example, sex is determined by an interaction between mitochondrial cytoplasmic male sterility (CMS) genes and nuclear restorer genes. Specifically, CMS involves aberrant mitochondrial genes that prevent pollen development and specific nuclear genes that restore it, leading to a mixture of female (male‐sterile) and hermaphroditic individuals in the population (...) (gynodioecy). Such a mitochondrial‐nuclear sex determination system is thought to be rare outside plants. Here, we present one possible case of CMS in animals. We hypothesize that the only exception to the strict maternal mtDNA inheritance in animals, the doubly uniparental inheritance (DUI) system in bivalves, might have originated as a mitochondrial‐nuclear sex‐determination system. We document and explore similarities that exist between DUI and CMS, and we propose various ways to test our hypothesis. (shrink)

Several methods of treatment for hepatocellular carcinoma are often used in combination for either palliation or cure. We established a multidisciplinary treatment team at the San Francisco Veterans Affairs Medical Center in November 2003 and assessed whether aggressive multimodality treatment strategies may affect survival. A prospective database was established and follow-up information from patients with presumed HCC was collected up to November 2006. Information from the American College of Surgeons cancer registry from January 2000 to November 2003 identified patients with (...) HCC that were evaluated at the same institution prior to the establishment of the MDTT. The establishment of a MDTT resulted in the doubling of patient referrals for treatment. Significantly more patients were evaluated at earlier stages of disease and received either palliative or curative therapies. The overall survival and length of follow-up were significantly improved after the establishment of the MDTT. Stage-by-stage comparisons indicate that aggressive multimodality therapy conferred significant survival advantage to patients with American Joint Commission on Cancer stage II HCC. Multidisciplinary collaboration and multimodality treatment approaches are important in the management of hepatocelluar carcinoma and improves patient survival. (shrink)

Bas van Fraassen argues that inference to the best explanation is a probabilistically incoherent rule. Anyone following IBE is open to being Dutch booked. According to one of the most interesting and popular responses to van Fraassen’s argument, van Fraassen misrepresents IBE in probabilistic terms. With the proper probabilistic representation, it is claimed, IBE is not inconsistent with Bayesian rationality constraints. Building on the work of IBE’s proponents, I first propose a minimal account of what makes one explanation better than (...) another. I then argue that, even on this minimal account, the alternative probabilistic model of IBE does not work, and hence fails to successfully respond to van Fraassen’s argument. (shrink)

Medical-legal partnerships (MLPs) — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. This article examines the unique, interrelated ethical issues that confront the clinical and legal partners (...) involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. The commonalities in ethical approaches represent a potential bridge between legal and health care advocacy for patient/client well-being. Bioethics has a role to play in building and analyzing this bridge: bioethics may serve as a discourse and method to enhance collaboration by highlighting common ethical foundations and refocusing legal and clinical partners on their similar goals of service for patients/clients. This article explores this bridging role of bioethics, through a series of case studies. It concludes with recommendations to strengthen the collaborations. (shrink)

Medical-legal partnerships — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. There are currently over 180 MLPs at over 200 hospitals and health centers in the United (...) States, with increasing federal interest and potential legislative support of this model.This article examines the unique, interrelated, and often similar ethical issues that confront the clinical and legal partners involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. (shrink)

In the United States, only 6% of the 1.5 million faculty in degree-granting postsecondary institutions is Black. Research shows that, while many institutions tout the idea of diversity recruitment, not much progress has been made to diversify faculty ranks, especially at research-intensive institutions. We're Not Ok shares the experiences of Black faculty to take the reader on a journey, from the obstacles of landing a full-time faculty position through the unique struggles of being a Black educator at a predominantly white (...) institution, along with how these deterrents impact inclusion, retention, and mental health. The book provides practical strategies and recommendations for graduate students, faculty, staff, and administrators, along with changemakers, to make strides in diversity, equity, and inclusion. More than a presentation of statistics and anecdotes, it is the start of a dialogue with the intent of ushering actual change that can benefit Black faculty, their students, and their institutions. (shrink)

This volume examines some of the most contentious social justice issues present in the corpus of Augustine's writings. Whether one is concerned with human trafficking and the contemporary slave trade, the global economy, or endless wars, these essays further the conversation on social justice as informed by the writings of Augustine of Hippo.

Context: Most constructivist discourse is situated at the philosophical-conceptual level, where arguments appeal to the intuition of the reader, while formal-computational models have only been taken into account to a very limited degree so far. Problem: Two types of problems need to be addressed: Synthetically, can constructivist concepts be turned into actual computational implementations? Can these be further conceptual developments in constructivist theory as such, or are they just an application thereof? Conceptually, does the notion of computation square with constructivist (...) approaches at all? Method: Paradigmatically, we discuss the meaning of “computational” in cognitive agents that comply with constructivist concepts. Also, we summarize the contributions. Results: From a constructivist point of view, the concept of “computational model” is ambiguous and depends on whether it is used in the sense of the computational(ist) theory of mind or simply as a tool. Implications: The insights presented in the contributions to this special issue point in the direction of a computational extension of constructivist approaches as well as a constructivist extension to computational approaches. However, while many of the questions we posed were discussed in the contributions and open peer commentaries, some of them were largely neglected and thus are subject to further discussion. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

In the UK, over 70% of AIDS, including new cases, is located in a few Districts in central London where the distribution of previously occurring and new cases is essentially confined to the original risk groups of homosexual/bisexual men, drug addicts of both sexes, and some of their sexual partners and consorts. But control policy is still based on the assumption that HIV has already spread from persons in these risk groups into the general population, and that it will spread (...) hereafter at an increased rate because of heterosexual transmission to cause a widespread epidemic of AIDS.The basis and implications of this policy were investigated in the South East region adjacent to London, Analysis of demographic and epidemiological data shows that, with one exception, there is very little extension of AIDS from affected Districts in London to the surrounding region or even to the suburban fringe. Where AIDS is prevalent, as in this exception, the distribution follows the same, original pattern which relates essentially to risks arising from life-styles. There is no significant association between the prevalence or spread of AIDS and conventional markers of deprivation, economic and social disadvantage.Allocations of personnel, services and expenditure, assessed from returns required under the AIDS Control Act of 1987 and official registration data, continue to follow the original policy assumptions. They are therefore unrelated to the numbers of existing and new cases, disproportionate and unrealistic. Claims that this widespread excess of effort is justified by the fact that AIDS has not spread to the general population are falsified by the continuation of cases almost exclusively in risk groups. There is nothing in the data required under the Act or in registrations in this main locus of AIDS in the UK to suggest any change in this or to justify continuation of current expenditure and redundant activities.There is no evidence in these data that ethnic variations in the resident populations of Districts are associated with variations in the prevalence of AIDS. However, the larger figures available in some of the national data do indicate a disproportionate increase in some minority ethnic groups. Further detail about risks factors in these groups are required and, meanwhile, effort and expenditure should be re-orientated toward treatment, contact tracing and other public health measures for more effective containment of the continuing spread of AIDS in all the high risk groups. (shrink)

In the UK, over 70% of AIDS, including new cases, is located in a few Districts in central London where the distribution of previously occurring and new cases is essentially confined to the original risk groups of homosexual/bisexual men, drug addicts of both sexes, and some of their sexual partners and consorts. But control policy is still based on the assumption that HIV has already spread from persons in these risk groups into the general population, and that it will spread (...) hereafter at an increased rate because of heterosexual transmission to cause a widespread epidemic of AIDS.The basis and implications of this policy were investigated in the South East region adjacent to London, Analysis of demographic and epidemiological data shows that, with one exception, there is very little extension of AIDS from affected Districts in London to the surrounding region or even to the suburban fringe. Where AIDS is prevalent, as in this exception, the distribution follows the same, original pattern which relates essentially to risks arising from life-styles. There is no significant association between the prevalence or spread of AIDS and conventional markers of deprivation, economic and social disadvantage.Allocations of personnel, services and expenditure, assessed from returns required under the AIDS Control Act of 1987 and official registration data, continue to follow the original policy assumptions. They are therefore unrelated to the numbers of existing and new cases, disproportionate and unrealistic. Claims that this widespread excess of effort is justified by the fact that AIDS has not spread to the general population are falsified by the continuation of cases almost exclusively in risk groups. There is nothing in the data required under the Act or in registrations in this main locus of AIDS in the UK to suggest any change in this or to justify continuation of current expenditure and redundant activities.There is no evidence in these data that ethnic variations in the resident populations of Districts are associated with variations in the prevalence of AIDS. However, the larger figures available in some of the national data do indicate a disproportionate increase in some minority ethnic groups. Further detail about risks factors in these groups are required and, meanwhile, effort and expenditure should be re-orientated toward treatment, contact tracing and other public health measures for more effective containment of the continuing spread of AIDS in all the high risk groups. (shrink)