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)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the (...) fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications. (shrink)

The ethical origins of James's pragmatism -- Religion and the refinement of James's pragmatism -- The ethical republic -- Citizen James -- Legacies and prospects.

This volume is a Norwegian/German collaboration lead by Trygve Wyller and Hans-Gunter Heimbrock.

The European Council called for a period of reflection in each of the member states of the European Union (EU) after the people of France and the Netherlands rejected the Constitutional Treaty in referendums in 2005. The present article offers a contribution to this process by reflecting on the prospects for institutional design and redesign in the EU, a topic that became even more relevant after the Irish ?no? to the Lisbon Treaty in June 2008. The discussions are based on (...) a historical perspective, and the article discusses what lessons can be drawn from Jean Monnet, viewed as an institutional designer on the European stage. The article argues that the successful establishment of the European Coal and Steel Community (ECSC) was a product of a robust deontological design in a constitutional moment for Europe, and that prospective designers in the EU can learn important lessons from how Monnet identified and exploited available spaces for institutional design. (shrink)

This article points out problems in current dynamic treatments of anaphora and provides a new account that solves these by grafting Muskens' Compositional Discourse Representation Theory onto a partial theory of types. Partiality is exploited to keep track of which discourse referents have been introduced in the text (thus avoiding the overwrite problem) and to account for cases of anaphoric failure. Another key assumption is that the set of discourse referents is well-ordered, so that we can keep track of the (...) order in which they have been introduced, allowing a semantic characterization of anaphoric accessibility across stretches of discourse. Unlike other dynamic approaches, the system defines semantic values for unresolved anaphors. This leads to a clear separation of monotonic and non-monotonic content (in this case anaphoric resolution) and arguably provides a sound basis for a non-monotonic theory of anaphoric resolution. (shrink)

No philistine, Thorstein Veblen thought humankind's innate impulse to imbue experience with aesthetic unity advanced all knowledge, and that the most beautiful objects, ideas, and actions met a standard of communal benefit reflecting humanity's naturally selected sociability. Though German idealism was an early influence, it clashed with Veblen's historicist critique of Western institutions, and it was William James's psychology that refined his ideas into a coherent aesthetics with ethical and political applications, by clarifying how instinct, habit, and environment could interact (...) to institutionalize standards of beauty subverting the native altruism of the aesthetic impulse. Over years of association with John Dewey, Veblen concluded that a redeemed and reflective will to behold and create beauty in and through selfless activity could advance a more efficient and egalitarian society, and that humans cooperatively shaping their environments for the common good could approximate the German tradition's ideal of harmonizing personal freedom and external reality. (shrink)

Most proposals for new international agreements aim to address important global challenges. If the goal is to solve problems, then the value of these agreements depends on their ability to influence the world — to shape norms, constrain behavior, facilitate cooperation, and mobilize action. A recent review of empirical studies has suggested that many international agreements fail to achieve their aspirations. The review indicates that the form in which states make commitments to each other — through an international legal agreement (...) or through other means — may not be as important as commonly thought. It is the content of the commitments and how these are supported by mechanisms to encourage implementation that matter the most. When developing proposals for new international agreements, like the one that has recently been proposed to address antibiotic resistance, attention to implementation mechanisms should therefore be equal to if not greater than the attention paid to its form. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:William James’s Ethical RepublicTrygve ThrontveitFor William James (1842–1910), all philosophical problems were ultimately ethical. In Pragmatism (1907), James invoked the logical theory of his friend Charles Peirce to argue that the “meaning” of any belief consisted solely in “what conduct it is fitted to produce.” There was “no difference in abstract truth,” he elaborated, “that doesn’t express itself in a difference in concrete fact and in conduct consequent upon (...) that fact, imposed on somebody, somehow, somewhere, and somewhen.” Indeed, James concluded that truth was not just reflected in the consequences of conduct but shaped by them: “Truth is made,” he wrote, “just as health, wealth, and strength are made, in the course of experience.”1 This major thesis of Pragmatism distilled a career spent describing an unfinished world, in which human thoughts and actions made differences for which thinkers and actors were responsible. As early as 1878, James insisted that beliefs imply action to advance goals, creating effects valued in light of those goals. The mind, he reiterated in his 1890 masterpiece The Principles of Psychology, is a “fighter for ends,” and thinking, a “moral act.” Later, in “The Will to Believe” (1896), James argued that when evidence is inconclusive, belief might create conditions in which hypotheses could be verified and potential goods realized—or lost. That frank (if often overlooked) assessment of the moral risks as well as rewards of intellectual life echoed James’s most explicitly ethical work, “The Moral Philosopher and the Moral Life” [End Page 255] (1891), where he asserted that when choosing what to believe, it is “simply our total character and personal genius that are on trial; and if we invoke any so-called philosophy, our choice and use of that also are but revelations of our personal aptitude or incapacity for moral life.”2In short, James, as John Dewey elegized in 1910, “was everywhere and always the moralist.”3 Yet for much of the twentieth century critics deemed James’s philosophy ethically vacuous, a warrant for moral solipsism. In 1909, Bertrand Russell criticized James for privileging belief over suspension of judgment, and thus encouraging people to live in private moral universes rather than seek objective grounding for common values. Today, some intellectual historians continue to echo Russell and likeminded contemporaries, judging ethical pragmatism tantamount to moral relativism, even moral apathy.4 Others, acknowledging James’s impassioned pronouncements on lynching, industrial conflict, imperialist expansion, and other public moral issues, have interpreted them as expressing a particularly cosmopolitan but otherwise unremarkable American liberalism, rather than a coherent moral philosophy.5These criticisms are unfounded, but understandable. They reflect a general [End Page 256] antipathy toward James’s broader conceptions of knowledge, truth, and experience, and frustration with his unorthodox mode of philosophizing. In Pragmatism, James followed Peirce in arguing that beliefs are not copies of reality, but “rules for action” resembling the probabilistic predictions guiding scientific inquiry. James, however, extended Peirce’s argument, claiming there is no static reality that beliefs can once-for-all describe. A self-proclaimed “radical empiricist,” James held that the universe is pluralistic, and the only reality accessible to human minds is constantly changing—not least through the ceaseless flux of human consciousness, a fact as natural and consequential as any other.6 This blurring of subject-object distinctions scandalized contemporaries. It also underpinned James’s equally scandalous claim that ideas not only demonstrate their meaning through conduct, but derive both meaning and value from their origins and verification in human activity. To ask what is true in such a world was to ask which ideas, moral or otherwise, allow people to navigate it successfully—which “carry us prosperously from any one part of our experience to any other part”—and which do not.7 Because of these commitments James never made hard distinctions between ethics and other branches of inquiry, or defined his ethics as a separable component of his philosophy easily analyzed on its own terms. Meanwhile, his further refusal to dislodge theory from practice has frustrated those conceiving ethics as a logically and temporally consistent program of conduct. Instead, James insisted that ethical principles emerge organically from individuals’ collective experience in... (shrink)

Much is known about the phenomenon of dignity, yet there is still a need for implementing this understanding in clinical practice. The main purpose of this study was to find out how persons suffering from multiple sclerosis experience and understand dignity and violation in the context of a rehabilitation ward. A phenomenological-hermeneutic approach was used to extract the meaningful content of narratives from 14 patients with multiple sclerosis. Data were collected by personal research interviews. The findings revealed three main themes: (...) (1) ‘invisibly captured in fatigue’; (2) ‘fighters’ law: one who does not ask will not receive’; and (3) ‘dignity is humanity’. The essence of the findings in this study is that dignity is humanity. According to the participants, dignity requires time and is experienced only in a context of empathy and mutual confidence. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

In this essay I respond to critical readers of my book, William James and the Quest for an Ethical Republic. I argue that James’s ultimate preoccupations are ethical, and that his ethical and moral writings constitute a rich resource for pluralistic societies seeking democratic tools for negotiating deep ideological, cultural, and religious differences, and for building a thriving commons.

Few remember Thorstein Veblen (1857-1929) as a connoisseur of beauty or champion of beauty’s importance to an institutionally modern and technologically sophisticated society. Similarly few credit Veblen with any constructive theory of politics. Yet Veblen’s conception of the beautiful, his account of its role in human cultural evolution, and his critique of its perversion in the industrialized societies of the nineteenth and early twentieth centuries are invaluable to contemporary social-aesthetic aims of political and economic reconstruction. In contrast to the Veblen (...) of memory, the real Veblen devoted significant intellectual energy to building a theory of what political thinkers today call public work: creative, negotiated, open-ended production of shared goods by individuals alert both to self-interest and collective needs. Partaking of the rich tradition of philosophical pragmatism, Veblen's social aesthetics also points to that tradition's continuing value for contemporary aesthetic, social, and political theory. Indeed, further augmented by recent advances in cultural evolutionary theory, Veblen’s pragmatist, public-work aesthetics suggests a vision of democratic citizenship defined by cooperative imagination, production, critique, and re-creation of a moral and material commonwealth. The so-called “bard of savagery,” therefore, is better understood as a “bard of democracy,” narrating the travails and affirming the ideals of a culture aspiring to self-government. His is a vision that might lend the fragmented field of social aesthetics a common, compelling narrative of its own. (shrink)

We offer a summary of the WHO Report "Making Fair Choices on the Path to Universal Health Coverage".

We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.

The Moral Nexus develops and defends a new interpretation of morality—namely, as a set of requirements that connect agents normatively to other persons in a nexus of moral relations. According to this relational interpretation, moral demands are directed to other individuals, who have claims that the agent comply with these demands. Interpersonal morality, so conceived, is the domain of what we owe to each other, insofar as we are each persons with equal moral standing. The book offers an interpretative argument (...) for the relational approach. Specifically, it highlights neglected advantages of this way of understanding the moral domain; explores important theoretical and practical presuppositions of relational moral duties; and considers the normative implications of understanding morality in relational terms. The book features a novel defense of the relational approach to morality, which emphasizes the special significance that moral requirements have, both for agents who are deliberating about what to do and for those who stand to be affected by their actions. The book argues that relational moral requirements can be understood to link us to all individuals whose interests render them vulnerable to our agency, regardless of whether they stand in any prior relationship to us. It also offers fresh accounts of some of the moral phenomena that have seemed to resist treatment in relational terms, showing that the relational interpretation is a viable framework for understanding our specific moral obligations to other people. (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)

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.

BackgroundIn precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed.MethodsWe distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a forced-choice (...) conjoint analysis pairs of hypothetical patients were presented, and we calculated the average marginal component effect of seven individual patient characteristics, to estimate how each of them influence doctors’ priority-setting decisions.ResultsA positive biomarker status increased the probability of being allocated the new drug, while older age, severe comorbidity and reduced physical function reduced the probability. Importantly, sex, education level and smoking status had no significant influence on the decision.ConclusionBiomarker status is perceived as relevant for priority setting decisions, alongside more well-known patient characteristics like age, physical function and comorbidity. Based on our results, we discuss a framework that can help clarify whether biomarker status should be seen as an ethically acceptable factor for providing unequal treatment to patients with the same disease. (shrink)

The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents’ dignity maintained, promoted or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in (...) this part of this study consisted of individual research interviews. Altogether, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: ‘A feeling of being abandoned’. The sub-themes are designated as follows: deprived of the feeling of belonging, deprived of dignity due to acts of omission, deprived of confirmation, deprived of dignity due to physical humiliation, deprived of dignity due to psychological humiliation and deprived of parts of life. (shrink)

The paper argues that, counter to Walter Sinnott-Armostrong and Ewen Kingston’s view, we are morally required to refrain from joyguzzling, i.e., driving a fuel-inefficient car for no other purpose than having a good time. It is undisputed that joyguzzling is an example of a situation where the uncoordinated actions of a large group of individuals lead to an undesirable outcome. Additionally, it is highly unlikely that any one individual’s actions will have a significant impact on that outcome. But there are (...) morally relevant differences between cases that share these characteristics. The paper clarifies the debate by introducing and discussing three different types of cases: drop-in-the-ocean cases, overkill cases and emergence cases. We argue that we may have moral obligations in drop-in-the-ocean cases, and that emissions of GHGs are not examples of overkill cases. Then we demonstrate through counterexamples that there are moral obligations in a subgroup of emergence cases we call joyguzzling-like cases. After criticizing the soundness of Kingston and Sinnott-Armstrong’s arguments, we critically address their relevance. We argue that Sinnott-Armstrong and Kingston fail to distinguish between two concepts of moral obligation — namely, autonomous and heteronomous moral obligation; that their most important arguments do not have any relevance to heteronomous obligations; and, finally, that heteronomous moral obligations are essential for social change. (shrink)

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are (...) presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed. (shrink)

This book provides a collection of sources, many of them fragmentary and previously scattered and hard to access, for the development of Peripatetic philosophy in the later Hellenistic period and the early Roman Empire. It also supplies the background against which the first commentator on Aristotle from whom extensive material survives, Alexander of Aphrodisias (fl. c. AD 200), developed his interpretations which continue to be influential even today. Many of the passages are here translated into English for the first time, (...) including the whole of the summary of Peripatetic ethics attributed to 'Arius Didymus'. (shrink)

R.I.G. Hughes presents a series of eight philosophical essays on the theoretical practices of physics. The first two essays examine these practices as they appear in physicists' treatises (e.g. Newton's Principia and Opticks ) and journal articles (by Einstein, Bohm and Pines, Aharonov and Bohm). By treating these publications as texts, Hughes casts the philosopher of science in the role of critic. This premise guides the following 6 essays which deal with various concerns of philosophy of physics such as laws, (...) disunities, models and representation, computer simulation, explanation, and the discourse of physics. (shrink)

We should approach this topic with great fear and respect. It is not a merely “academic” issue. Human rights are trampled upon in the East as in the West, in the North as in the South of our planet. Granting the part of human greed and sheer evil in this universal transgression, could it not also be that Human Rights are not observed because in their present form they do not represent a universal symbol powerful enough to elicit understanding and (...) agreement? (shrink)

Chemical structures are among the trademarks of our profession, as surely chemical as flasks, beakers and distillation columns. When someone sees one of us busily scribbling formulas or structures, he or she has no trouble identifying a chemist. Yet these familiar objects, which accompany our work from start to end, from the initial doodlings (Fig. I) to the final polished artwork in a publication (Fig. II), are deceptively simple. They raise interesting and difficult questions about representation. It is the intent (...) of this article to reflect upon molecular graphics. (shrink)

Ethics and Decision Making in Counseling and Psychotherapy has a distinct and timely focus on counseling as a profession. Chapters address the mental health professions, values in counseling, decision making, ethical principles, ethical standards, technology, ethical climate, and office/administrative practices. The early chapters present a foundation for ethical practice of the profession and provides solid building blocks to the more advanced perspectives in later chapters. Chapters on specialty practice are lively and contemporary overviews of these practice areas in counseling that (...) reflect more recent trends to increased differentiation of these areas of practice. Each specialty has its own chapter to allow for an extended discussion of the unique aspects of the field that provide clarity to understanding the particular ethical issues and standards that apply in each specialty. The specialty areas recognized by CACREP are included: mental health counseling; school counseling; couple, marital, and family counseling; rehabilitation counseling; addictions counseling; career counseling; and group counseling. This book is broad in its coverage of the most practiced specialties in mental health practice, and provides an efficient and effective overview of the broad scope of particular areas addressed in counseling. (shrink)

How do we explain violence? What is so significant of modern forms of violence that it has produced such large-scale destruction in its wake? This volume builds on the political philosophy of Wittgenstein, his notions of peace and violence, to explore how violence in any form is contained within culturally or ideologically formed institutions. Drawing on Wittgenstein's work on language, it explores the link between language and violence, everydayness, culture. It examines everyday instances of micro-violence which we sometimes forget to (...) recall. This book puts forth the claim that any theory of violence will have to touch upon the many myriad - both micro and macro -- political, social and cultural interactions that make up the human condition. The author further comments on the unseen ways in which violence has been instrumentalized in modern history's many stages to create a spectacle of power so as to reinforce authority. The volume will be of great interest to students and scholars of peace and conflict studies, political philosophy, linguistics and modern history. (shrink)

The study was conducted in East Shewa, central Ethiopia, where durum wheat landraces were once popular, but were displaced and re-introduced. Combinations of survey techniques are employed to document the different home uses of durum wheat landraces and to assess whether these serve as an incentive to on-farm conservation. The findings reveal that wheat landraces have multiple dietary and sociocultural uses that contribute to the maintenance of landraces on-farm. Temporal analysis of historical information showed that (1) richness in food traditions (...) is associated with a high level of landrace diversity on-farm; (2) food traditions in East Shewa did not change radically as a result of the integration of farmers into the market economy; and (3) farm households still have an appreciation of, and a preference for, the home-use related qualities of the landraces, this despite their long term disappearance and the subsequent availability of several improved wheat varieties. The study illustrates the relationship between the local availability of landrace wheats and their on-farm survival. The home uses of landraces plays an instrumental role in the promotion of on-farm (in situ) conservation. Augmenting conservation activities with non-breeding approaches (e.g., awareness-creation) would support the survival of wheat landraces for the foreseeable future. (shrink)

Aesthetics in philosophy of mathematics is too narrowly construed. Beauty is not the only feature in mathematics that is arguably aesthetic. While not the highest aesthetic value, being interesting is a sine qua non for publishability. Of the many ways to be interesting, being explanatory has recently been discussed. The motivational power of what is interesting is important for both directing research and stimulating education. The scientific satisfaction of curiosity and the artistic desire for beautiful results are complementary but both (...) aesthetic. (shrink)

Karl Raimund Poppers (1902-1994) Hauptwerk, die Logik der Forschung (1934), gilt als Grundlagenwerk des kritischen Rationalismus. Der kritische Rationalismus zeigt, warum unser Wissen fehlbar ist und versteht den Erkenntnisfortschritt als Resultat von Hypothesenbildung und -widerlegung. Der Sammelband orientiert sich an der Gliederung der Logik der Forschung. Seine Beiträge kommentieren die jeweiligen Themen nach aktueller Forschungslage.