‘[Valerius'] Argonautica is a story of high adventure, not a poème à thèse’: so stated Garson in 1965. Strand later added that the essential nature of this poem and the choice of subject-matter was determined by poetic inability; he describes the prooemium to Valerius' Argonautica as ‘a recusatio: the theme of the fall of Jerusalem is beyond his powers, and it would instead be treated by Domitian who was fit for such an arduous task; Valerius had to content himself with (...) the theme of an old myth’. It is these two opinions that I wish to question in this article. Indeed, alarm bells immediately sound at Strand's interpretation of the poet's recusatio. It has long been recognized that the original Callimachean recusatio was twisted by the Augustan poets. Gordon Williams analyses their practice thus: ‘They sadly regret that their poor talents will not rise to great subjects – and the subjects to which they will not rise are not the old mythological tales but the great affairs of contemporary Roman history and, in particular, the deeds of Augustus. It is clear, however, that they are using this form of poem to enumerate and praise the great deeds of Augustus, under the guise of proposing their own inability.’ No-one hesitates to agree that Valerius was well versed in the Augustan poets. It is dangerous, therefore, to assume without question that he was deceived by their insincerity. There is in fact good reason to examine the alternative possibility, namely that Valerius understood well the practice of his literary predecessors, that he dared to tread in their footsteps and that he succeeded in the supreme duty of a poet, that is to say, the business of ensuring that ars celavit artem. (shrink)

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can (...) impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. Funding Disclosure: This work was supported in part by the Intramural Program of the National Institutes of Health Clinical Center. - [1] John J Mulvihill et al., “Ethical Issues of CRISPR Technology and Gene Editing through the Lens of Solidarity,” British Medical Bulletin 122 (2017): 17–29, https://doi.org/10.1093/bmb/ldx002; Ben Saunders, “Altruism or Solidarity? The Motives for Organ Donation and Two Proposals,” Bioethics 26, no. 7 (September 2012): 376–81, https://doi.org/10.1111/j.1467-8519.2012.01989.x; -Vanessa Y Hiratsuka, “SPECIAL REPORT: A Critical Moment in Bioethics: Reckoning with Anti-Black Racism through Intergenerational Dialogue A Call for Solidarity in Bioethics: Confronting Anti-Black Racism Together,” 2022, https://doi.org/10.1002/hast.1380. [2] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [3] Bob Simpson, “A ‘We’ Problem for Bioethics and the Social Sciences: A Response to Barbara Prainsack,” Science, Technology, & Human Values 43, no. 1 (January 12, 2018): 45–55, https://doi.org/10.1177/0162243917735899. [4] Barbara Prainsack and Alena Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics (London: Nuffield Council on Bioethics, 2011). [5] Barbara Prainsack and Alena Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach,” Bioethics 26, no. 7 (September 2012): 343–50, https://doi.org/10.1111/J.1467-8519.2012.01987.X. [6] Bridget Pratt, Phaik Yeong Cheah, and Vicki Marsh, “Solidarity and Community Engagement in Global Health Research,” The American Journal of Bioethics : AJOB 20, no. 5 (May 3, 2020): 43–56, https://doi.org/10.1080/15265161.2020.1745930; Sara Chandros Hull, F. Leah Nez (Diné), and Juliana M. Blome, “Solidarity as an Aspirational Basis for Partnership with Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 14–17, https://doi.org/10.1080/15265161.2021.1965258; Mbih J. Tosam et al., “Global Health Inequalities and the Need for Solidarity: A View from the Global South,” Developing World Bioethics 18, no. 3 (September 1, 2018): 241–49, https://doi.org/10.1111/DEWB.12182. [7] Peter West-Oram, “Solidarity Is for Other People: Identifying Derelictions of Solidarity in Responses to COVID-19,” Journal of Medical Ethics 47, no. 2 (February 1, 2021): 65–68, https://doi.org/10.1136/MEDETHICS-2020-106522; Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215; F. Marijn Stok et al., “Social Inequality and Solidarity in Times of COVID-19,” International Journal of Environmental Research and Public Health 18, no. 12 (June 2, 2021), https://doi.org/10.3390/IJERPH18126339; Ming Jui Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics,” American Journal of Public Health 112, no. 2 (February 1, 2022): 255–61, https://doi.org/10.2105/AJPH.2021.306578; Barbara Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.,” Am J Public Health 112, no. 2 (February 1, 2022): 232–33, https://doi.org/10.2105/AJPH.2021.306619. [8] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [9] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [10] Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics”; Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” [11] Ho, Anita, and Iulia Dascalu. "Relational solidarity and COVID-19: an ethical approach to disrupt the global health disparity pathway." Global Bioethics 32, no. 1 (2021): 34-50; West-Oram, Peter. "Solidarity is for other people: identifying derelictions of solidarity in responses to COVID-19." Journal of Medical Ethics 47, no. 2 (2021): 65-68. [12] Monica Webb Hooper, Anna María Nápoles, and Eliseo J. Pérez-Stable, “COVID-19 and Racial/Ethnic Disparities,” JAMA 323, no. 24 (June 23, 2020): 2466, https://doi.org/10.1001/jama.2020.8598. [13] Prainsack, Barbara. “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” Am J Public Health 112, no. 2 (February 1, 2022): 232–33. https://doi.org/10.2105/AJPH.2021.306619. [14] Camille A Clare, “Telehealth and the Digital Divide as a Social Determinant of Health during the COVID-19 Pandemic,” Network Modeling Analysis in Health Informatics and Bioinformatics 10 (2021): 26, https://doi.org/10.1007/s13721-021-00300-y. [15] Patrick Nana-Sinkam et al., “Health Disparities and Equity in the Era of COVID-19,” Journal of Clinical and Translational Science 5, no. 1 (March 16, 2021): e99, https://doi.org/10.1017/cts.2021.23. [16] Kathryn M Leifheit et al., “Expiring Eviction Moratoriums and COVID-19 Incidence and Mortality,” American Journal of Epidemiology 190, no. 12 (December 1, 2021): 2503–10, https://doi.org/10.1093/aje/kwab196. [17] Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215 [18] Maximilian Agostini and Martijn van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.,” Psychological Bulletin 147, no. 7 (July 2021): 667–700, https://doi.org/10.1037/bul0000256. [19] Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (HHS/CDC), “COVID Data Tracker,” 2023, https://covid.cdc.gov/covid-data-tracker. [20] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 9 and Chapter 4 [21] Powers and Faden, Social Justice: The Moral Foundation of Public Health and Health Policy; Madison Powers and Ruth Faden, Structural Injustice: Power, Advantage, and Human Rights (New York: Oxford University Press, 2019). [22] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 10 [23] Bobby Saunkeah et al., “Extending Research Protections to Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 5–12, https://doi.org/10.1080/15265161.2020.1865477. [24] Agostini and van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.” [25] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics. [26] Ruth Chadwick, “COVID‐19 and the Possibility of Solidarity,” Bioethics 34, no. 7 (September 8, 2020): 637–637, https://doi.org/10.1111/bioe.12813. (shrink)

In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005–2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration – the (...) universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships – with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse. (shrink)

On August 28, 2008, Michael Marmot, Chair of the Commission on Social Determinants of Health, formally handed over the Commission’s Final Report to Margaret Chan, the Director-General of the World Health Organization, at the Palais des Nations in Geneva. It was a significant moment. Dr. Chan addressed a hall packed with representatives of the world’s communications media in a speech that was remarkably direct. Dr. Chan reiterated the Commission’s position that to improve health and health equity action needs to be (...) taken not just across the health sector but across all social and economic policy areas, and stated, “Social deprivation is not a matter of fate. It is a marker of policy failure.” This was a bold statement from one of the world’s leading diplomats. Policy failure! The phrase echoes the Commission’s assertion that “a toxic combination of poor social policies, unfair economic arrangements and bad politics is killing people on a grand scale.” The Commission’s messages are far reaching. (shrink)

Part I: WHAT IS ETHICS? Plato: Socratic Morality: Crito. Suggestions for Further Reading. Part II: ETHICAL RELATIVISM VERSUS ETHICAL OBJECTIVISM. Herodotus: Custom is King. Thomas Aquinas: Objectivism: Natural Law. Ruth Benedict: A Defense of Ethical Relativism. Louis Pojman: A Critique of Ethical Relativism. Gilbert Harman: Moral Relativism Defended. Alan Gewirth: The Objective Status of Human Rights. Suggestions for Further Reading. Part III: MORALITY, SELF-INTEREST AND FUTURE SELVES. Plato: Why Be Moral? Richard Taylor: On the Socratic Dilemma. David Gauthier: (...) Morality and Advantage. Gregory Kavka: A Reconciliation Project. Derek Parfit: Later Selves and Moral Principles. Bernard Williams: Persons, Character, and Morality. Suggestions for Further Reading. Part IV: VALUE. Jeremy Bentham: Classical Hedonism. Robert Nozick: The Experience Machine. Richard Taylor: Value and the Origin of Right and Wrong. Friedrich Nietzsche: The Transvaluation of Values. Derek Parfit: What Makes Someone’s Life Go Best? Thomas Nagel: Value: The View from Nowhere. Suggestions for Further Reading. Part V: UTILITARIANISM AND CONSEQUENTIALISM. John Stuart Mill: Utilitarianism. J.J.C. Smart: Extreme and Restricted Utilitarianism. Kai Nielsen: Against Moral Conservatism. Bernard Williams: Against Utilitarianism. John Hospers: Rule-Utilitarianism. Robert Nozick: Side Constraints. Peter Singer: Famine, Affluence and Morality. Suggestions for Further Reading. Part VI: KANTIAN AND DEONTOLOGICAL SYSTEMS. Immanuel Kant: Foundation for the Metaphysic of Morals. W. D. Ross: What Makes Right Acts Right? Onora O’Neill: Kantian Formula of the End in Itself and World Hunger. Thomas Nagel: Moral Luck. Philippa Foot: Morality as a System of Hypothetical Imperatives. Judith Jarvis Thomson: Killing, Letting Die, and the Trolley Problem. Suggestions for Further Reading. Part VII: CONTRACTARIAN ETHICAL SYSTEMS. Thomas Hobbes: The Leviathan. David Gauthier: Why Contractarianism? John Rawls: Contractualism: Justice as Fairness. T.M. Scanlon: Contractualism and Utilitarianism. Suggestions for Further Reading. Part VIII: VIRTUE-BASED ETHICAL SYSTEMS. Aristotle: The Ethics of Virtue. Bernard Mayo: Virtue and the Moral Life. William Frankena: A Critique of Virtue-Based Ethics. Walter Schaller: Are Virtues No More than Dispositions to Obey Moral Rules? Alasdair MacIntyre: The Nature of the Virtues. Susan Wolf: Moral Saints. Louis P. Pojman: In Defense of Moral Saints. Suggestions for Further Reading. Part IX: THE FACT/VALUE PROBLEM: METAETHICS IN THE TWENTIETH CENTURY. David Hume: On Reason and the Emotions: The Fact/Value Distinction. G. E. Moore: Non-Naturalism. A. J. Ayer: Emotivism. R. M. Hare: Prescriptivism: The Structure of Ethics and Morals. Geoffrey Warnock: The Object of Morality. Suggestions for Further Reading. Part X: MORAL REALISM AND THE CHALLENGE OF SKEPTICISM. J.L. Mackie: The Subjectivity of Values. Jonathan Harrison: A Critique of Mackie’s Error Theory. Gilbert Harman: Moral Nihilism. Nicholas Sturgeon: Moral Explanations. Bernard Williams: Ethics and the Limits of Philosophy. Bruce Russell: Two Forms of Ethical Skepticism. Michael Smith: A Defense of Moral Realism. Suggestions for Further Reading. Part XI: RELIGION AND ETHICS. Plato: Morality and Religion. Immanuel Kant: God and Immortality as Necessary Postulates of Morality. George Mavrodes: Religious and the Queerness of Morality. Kai Nielson: Ethics Without God. Suggestions for Further Reading. Part XII: CONTEMPORARY CHALLENGES TO CLASSICAL ETHICAL THEORY. Part A. Sociobiology and the Question of Moral Responsibility. Charles Darwin: Ethics and the Descent of Man. E.O.Wilson: Sociobiology and Ethics. Michael Ruse: Evolution and Ethics: The Sociobiological Approach. Elliot Sober: Prospects for an Evolutionary Ethics. J.L. Mackie: The Law of the Jungle, Evolution and Morality. Suggestions for Further Readingon Sociobiology. Part B. The Challenge of Determinism to Moral Responsibility and Desert. Galen Strawson: The Impossibility of Moral Responsibility. Louis Pojman: Free Will, Determinism, and Moral Responsibility:A Response to Galen Strawson. Richard Taylor: A Libertarian Defense of Free Will and Responsibility. Suggestions for Further Reading on Moral Responsibility. Glossary of Ethical Terms. (shrink)

Anne Conway was an extraordinary figure in a remarkable age. Her mastery of the intricate doctrines of the Lurianic Kabbalah, her authorship of a treatise criticising the philosophy of Descartes, Hobbes, and Spinoza, and her scandalous conversion to the despised sect of Quakers indicate a strength of character and independence of mind wholly unexpected in a woman at the time. Translated for the first time into modern English, her Principles of the Most Ancient and Modern Philosophy is the most interesting (...) and original philosophical work written by a woman in the seventeenth century. Her radical and unorthodox ideas are important not only because they anticipated the more tolerant, ecumenical, and optimistic philosophy of the Enlightenment, but also because of their influence on Leibniz. This fully annotated edition includes an introduction which places Conway in her historical and philosophical contexts, together with a chronology of her life and a bibliography. (shrink)

The population of Campobasso Province shows a level of inbreeding that is distinct from most Italian rural populations, regardless of their geographic location (Fr=0·0040; Fn=0·0102; Ft=0·0142). The genetic structure of the ItalianGreeks of Reggio Calabria Province is similar to other Italians of Campobasso Province (Fr=0·0041; Fn=0·0127; Ft=0·0168). The Italian–Greeks of Lecce Province show random mating, and their inbreeding is in fact very low (Fr=0·0038; Fn=0·0024; Ft=0·0062).

Anne Conway’s Principles of the Most Ancient and Modern Philosophy, first published in 1690, is probably the most ambitious contribution to early modern metaphysics by a woman writing in the English language. This beautifully prepared edition makes Conway’s treatise available to twentieth-century readers in an accessible English translation of the 1690 Latin text—itself a translation of an original English manuscript that has long been lost.

BackgroundThe triangle completion test has been used to assess egocentric wayfinding for decades, yet there is little information on its reliability. We developed a virtual reality based test and investigated whether either test of spatial navigation was reliable.ObjectiveTo examine test-retest reliability of the real-world and VR triangle completion tests. A secondary objective was to examine the usability of the VR based test.Materials and methodsThirty healthy adults aged 18–45 years were recruited to this block randomized study. Participants completed two sessions of (...) triangle completion tests in the real-world and VR on the same day with a break between sessions.ResultsIn both test versions distance from the endpoint and angle of deviation showed poor test-retest reliability. Distance traveled had moderate reliability in both the real-world and VR tests. The VR triangle test showed poor correlation with the real-world test.ConclusionThe triangle completion test has poor test-retest reliability and demonstrates poor concurrent validity between the real-world and VR. Nevertheless, it was feasible to translate a real-world test of spatial navigation into VR. VR provides opportunities for development of clinically relevant spatial navigation tests in the future. (shrink)

The epidemic of COVID-19 appears to be reshaping the world, separating before and after, present and past. Its perceived novelty raises the question of what role the past might play in the present epidemic and in responses to it. Taking the view that the past has not passed, but is present in is material and immaterial remains, and continuously emerging from these, we argue that it should not be studied as closed narration but through the array of its traces, which (...) constitute the texture of the present. To that end, and building on long-term ethnographic research on past and present epidemics in western Kenya, we assemble here some preliminary observations on the first weeks of COVID-19 in Kenya. We explore how the acute epidemic crisis currently unfolding is intertwined with layered fragments of earlier epidemic events, attending to material infrastructures, institutional practices, and ritual responses, to the presence of virally loaded bodies, pharmaceuticals, and their residues, and to the resurgence of often painful memories and emotions. People in this region have experienced a long century of epidemics and anti-epidemic measures of varying duration and intensity, from colonial and postcolonial sleeping sickness and smallpox to HIV/AIDS and more recently cancer, alongside actual or anticipated outbreaks of cholera and Ebola. This local perception of one long epidemic qualifies the notion of a radical temporal break that the COVID-19 pandemic is often associated with in European conversations. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

This article identifies a prevalent strand of feminist writing on beauty and aesthetic surgery and explores some of the contradictions and inconsistencies inscribed within it. In particular, we concentrate on three central feminist claims: that living in a misogynist culture produces aesthetic surgery as an issue predominantly concerning women; that pain - both physical and psychic - is a central conceptual frame through which aesthetic surgery should be viewed; and that aesthetic surgery is inherently a normalizing technology. Engaging with these (...) ‘myths’, we explore the tensions uncovered through a historical analysis of the practices of aesthetic surgery as well as the challenges to feminist claims offered by post-feminism. In particular we seek to destabilize the connection in feminist writing between beauty and passivity. We argue that through aesthetic references to denigrated black and working-class bodies, young women may mobilize aesthetic surgeries to reinscribe active sexuality on the feminine body. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

In this essay, P. Taylor Webb and Kalervo N. Gulson argue that educational policy is a spatial process and that implementation processes in particular produce crucial emergent geographies for policy research. Webb and Gulson describe how emergent geographies are produced when policy folds actors through senses and enactments of policy. The idea that policy is sensed and enacted is developed into the concept of a policy intension that extends approaches to spatial and, in particular, micropolitical analyses in policy research. (...) Webb and Gulson conclude by discussing cartographical methods that better map the geographies of subjectivity produced through policy intensions. (shrink)

Clinical simulation is used in nursing education and in other health professional programs to prepare students for future clinical practice. Simulation can be used to teach students communication skills and how to deliver bad news to patients and families. However, skilled communication in clinical practice requires students to move beyond simply learning superficial communication techniques and behaviors. This article presents an unexplored concept in the simulation literature: the exercise of moral imagination by the health professional student. Drawing from the works (...) of Hume, Aristotle and Gadamer, a conceptualization of moral imagination is first provided. Next, this article argues that students must exercise moral imagination on two levels: towards the direct communication exchange before them; and to the representative nature of simulation encounters. Last, the limits of moral imagination in simulation-based education are discussed. (shrink)

Philosophy: The Big Questions occupies a unique position among introductory texts in philosophy. Designed for a single-semester introductory course in philosophy, it includes both classic readings in philosophy and newer articles. Presents, in one volume, canonical and contemporary works in ethics, metaphysics, philosophy of religion, and epistemology. Topics discussed include knowledge, religion, freedom, morality, and the meaning of life. Serves as a comprehensive and compelling introduction to philosophy. Together with traditional readings it also presents non-traditional, feminist eadings from a continental (...) perspectives. (shrink)

Contemporary bioethical issues are inherently cross-cultural and global in their scope. This is not surprising, as bioethical matters touch everyone in one way or another. Moral quandaries in health-care, life sciences, and biotechnology do not respect natural and human boundaries, the boundaries between and within nation-states, ethnicities, cultures, communities, and social groups. In addition, the simultaneously large-scale and intimate interactions between and within different cultures and civilizations and the rapid pace at which they change are phenomena that distinguish our times (...) from previous eras. Bioethics—as a particular domain of public discourse and an academic discipline—has thus been rapidly... (shrink)

I argue that four-dimensionalism and the desire satisfaction account of well-being are incompatible. For every person whose desires are satisfied, there will be many shorter-lived individuals (‘person-stages’ or ‘subpersons’) who share the person’s desires but who do not exist long enough to see those desires satisfied; not only this, but in many cases their desires are frustrated so that the desires of the beings in whom they are embedded as proper temporal parts may be fulfilled. I call this the frustrating (...) problem for four-dimensionalism. In the first half of the paper I lay the groundwork for understanding the frustrating problem, and then in the second half, I will examine six possible responses to the frustrating problem on behalf of the four-dimensionalist, (i) the Parfit (1984) inspired claim that identity is not what matters, (ii) the personal pronoun revisionism of Noonan (2010), (iii) the indirect concern account of Hudson (2001), (iv) the sensible stages account of Lewis (1986), (v) a multiple-concepts account of desire satisfaction, and (vi) a No Desire View according to which subpersons have no mental states and thus no desires to frustrate. I argue that none of these solutions will help the four-dimensionalist; she does better to reject the desire satisfaction theory, while the defender of the desire satisfaction theory does better to reject four-dimensionalism. (shrink)

"Paleontologists like to say that to a first approximation, all species are extinct (ninety- nine percent is the usual estimate). The organisms we see around us are distant cousins, not great grandparents; they are a few scattered twig-tips of an enormous tree whose branches and trunk are no longer with us." (p. 343-44). The historical life bush consists mainly in dead ends.