Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates (...) of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease. (shrink)

Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates (...) of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease. (shrink)

The literature on cross-sector partnerships has increasingly focused attention on broader systemic or system-level change. However, research to date has been partial and fragmented, and the very idea of systemic change remains conceptually underdeveloped. In this article, we seek to better understand what is meant by systemic change in the context of cross-sector partnerships and use this as a basis to discuss the contributions to the Thematic Symposium. We present evidence from a broad, multidisciplinary systematized review of the extant literature, (...) develop an original definition of systemic change, and offer a framework for understanding the interactions between actors, partnerships, systemic change, and issues. We conclude with some suggestions for future research that we believe will enhance the literature in its next phase of development. (shrink)

The focus of this article is on multi-organizational cross-sector social partnerships (CSSP), an increasingly common means of addressing complex social and ecological problems that are too extensive to be solved by any one organization. While there is a growing body of literature on CSSP, there is little focus on collaborative strategic management, especially where implementation and outcomes are concerned. This study addresses these gaps by offering a conceptual model of collaborative strategic management, which is then tested through the use of (...) two qualitative empirical cases of collaborative regional sustainable development strategies (CRSDS). The model augments previous collaboration models by highlighting two levels of implementation (the collaboration and the organizational levels) and by considering the different types of outcomes, and the feedback loops. (shrink)

Systems change requires complex interventions. Cross-sector partnerships face the daunting task of addressing complex societal problems by aligning different backgrounds, values, ideas and resources. A major challenge for CSPs is how to link the type of partnership to the intervention needed to drive change. Intervention strategies are thereby increasingly based on Theories of Change. Applying ToCs is often a donor requirement, but it also reflects the ambition of a partnership to enhance its transformative potential. The current use of ToCs in (...) partnering efforts varies greatly. There is a tendency for a linear and relatively simple use of ToCs that does limited justice to the complexity of the problems partnerships aim to address. Since partnership dynamics are already complex and challenging themselves, confusion and disagreement over the appropriate application of ToCs is likely to hamper rather than enhance the transformative potential of partnerships. We develop a complexity alignment framework and a diagnostic tool that enables partnerships to better appreciate the complexity of the context in which they operate, allowing them to adjust their learning strategy. This paper applies recent insights into how to deal with complexity from both the evaluation and theory of change fields to studies investigating the transformative capacity of partnerships. This can serve as a check to define the challenges of partnering projects and can help delineate the societal sources and layers of complexity that cross-sector partnerships deal with such as failure, insufficient responsibility taking and collective action problems at four phases of partnering. (shrink)

The recent trend in institutional communication research seems to foster the image of the University as a private organization significantly oriented towards a policy of customer satisfaction. Following the concept of organizational culture, institutional settings too are conceived as organizational contexts, where discourse is a privileged vehicle to convey and spread values, traditions and artifacts, both through internal and external communication practices. Thus, within academic discourse organizational culture is shaped and perpetuated by specific devices of rhetorical argumentation. The corpus of (...) data consists of two different examples of academic discourse: the self promotional endorsement letters of the academic candidates to the chancellor’s position on occasion of the elections and the inaugural speeches proclaimed by the chancellors in charge during the opening celebration of the academic year. The first kind of academic discourse could be meant as an example of political discourse since the candidates use communication strategically and manipulate their academic membership as a rhetorical device to support their aims. On the other hand, the second example is a mere celebration of academic culture which through linguistic rituals recalls and perpetuates the basic values of this microcosm. The data have been analysed with the critical discourse analysis and diatextual analysis which pay particular attention to the context of speech. Moreover, attention has been focused on the metaphors and on the meta-discursive cues. The results show that although with different purposes academic discourse use similar discursive and rhetorical strategies as both belong to the same organization. (shrink)

In its expansion to genomic, epidemiological and biomedical research, citizen science has been promoted as contributing to the democratisation of medical research and healthcare. At the same time, it has been criticised for reinforcing patterns of exclusion in health and biomedicine, and sometimes even creating new ones. Although citizen science has the potential to make biomedical research more inclusive, the benefits of current citizen science initiatives are not equally accessible for all people—in particular those who are resource-poor, located outside of (...) traditional networks of healthcare services, or members of minorities and marginalised groups. In view of growing public investments in participatory research endeavours, we argue that it should be considered more explicitly if, and how, citizen science could help make research more inclusive, contribute to the public good, and possibly even lead to better and more equitable healthcare. Reflecting on emerging ethical concerns for scientific conduct and best medical practice, we propose a set of relevant considerations for researchers, practitioners, bioethicists, funders and participants who seek to advance ethical practices of citizen-led health initiatives, and address profound differences in position, privilege and power in research. (shrink)

This essay interrogates the common assumption that good care is necessarily human care. It looks to disruptive fictional representations of robot care to assist its development of a theory of posthuman care that jettisons the implied anthropocentrism of ethics of care philosophy but retains care’s foregrounding of entanglement, embodiment and obligation. The essay reads speculative representations of robot care, particularly the Swedish television programme Äkta människor (Real Humans), alongside ethics of care philosophy and critical posthumanism to highlight their synergetic critiques (...) of neoliberal affective economies and humanist hierarchies that treat some bodies and affects as more real than others. These texts and discourses assist me in proposing a theory of care that regards vulnerability as the normative effect of posthuman vital embodiment, as opposed to an anomalous state that can be overcome or corrected via neoliberal practice. (shrink)

In this paper, I argue that the fetishism objection to moral hedging fails. The objection rests on a reasons-responsiveness account of moral worth, according to which an action has moral worth only if the agent is responsive to moral reasons. However, by adopting a plausible theory of non-ideal moral reasons, one can endorse a reasons-responsiveness account of moral worth while maintaining that moral hedging is sometimes an appropriate response to moral uncertainty. Thus, the theory of moral worth upon which the (...) fetishism objection relies does not, in fact, support that objection. (shrink)

Several philosophers have recently argued that decision-theoretic frameworks for rational choice under risk fail to provide prescriptions for choice in cases of moral uncertainty. They conclude that there are no rational norms that are “sensitive” to a decision-maker's moral uncertainty. But in this paper, I argue that one sometimes has a rational obligation to take one's moral uncertainty into account in the course of moral deliberation. I first provide positive motivation for the view that one's moral beliefs can affect what (...) it's rational for one to choose. I then address the problem of value comparison, according to which one cannot determine the expected moral value of one's actions. I argue that we should not infer from the problem of value comparison that there are no rational norms governing choice under moral uncertainty. (shrink)

When considering the introduction of AI to support medical decision-making, one must take an end-to-end, holistic approach to development, evaluation, integration and governance. (Cabitza and Zeito...

Recent research shows that in reasoning tasks, subjects usually produce an initial intuitive answer, accompanied by a metacognitive experience, which has been called feeling of rightness. This paper is aimed at exploring the complimentary experience of feeling of error, that is, the spontaneous, subtle sensation of cognitive uneasiness arising from conflict detection during thinking. We investigate FOE in two studies with the “bat-and-ball” reasoning task, in its standard and isomorphic control versions. Study 1 is a generation study, in which participants (...) are asked to generate their own response. Study 2 is an evaluation study, in which participants are asked to choose between two conflicting answers. In each study, the FOE is measured by the FOE questionnaire. Results show that the FOE is significantly present in the standard B&B task when participants give a wrong answer, that our questionnaire can measure it, and furthermore, that it is diagnostic of genuine error. (shrink)

In this paper, I present an argument that quantitative behavioural analysis can be used in zoosemiotic studies to advance the field of biosemiotics. The premise is that signs and signals form patterns in space and time, which can be measured and analysed mathematically. Whole organism sign processing is an important component of the semiosphere, with individual organisms in their Umwelten deriving signs from, and contributing to, the semiosphere, and vice versa. Moreover, there is a wealth of data available in the (...) traditional ethology literature which can be reinterpreted semiotically and drawn together to make a cohesive biosemiotic whole. For example, isolated signals, such as structural elements of birdsong, are attributed meaning by an interpreter, thus generating new ideas and hypotheses in both biology and semiotics. Furthermore, animal behaviour science has developed numerous test paradigms that with careful adaptation, could be suitable for use within a Peircean tripartite model, and thus give valuable insights into Umwelten of other species. In my conclusion, I suggest that by bringing together traditional ethology and biosemiotics, it is possible to use the Modern Synthesis to provide context to biosemiosis, thus pragmatic meaning to animal signals. On this basis, I propose updating the Modern Synthesis to a Semiotic Modern Synthesis, which focuses on whole-organism signals and their contexts, the latter being derived from neo-Darwinian theory and the ‘Umwelt’. Thus, there need be no dichotomy; the Modern Synthesis can successfully be integrated with biosemiotics. (shrink)

In this case, an adolescent with a life-threatening immune disease experiences increased social complexity, child welfare involvement, and placement into foster care, which could disrupt a medical...

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

Here, I outline the idea of a unified hypothesis of sensory perception, developed from the theoretical vibrational mechanism of olfaction, which can be applied across all sensory modalities. I propose that all sensory perception is based upon the detection of mechanical forces at a cellular level, and the subsequent mechanotransduction of the signal via the nervous system. Thus, I argue that the sensory modalities found in the animal kingdom may all be viewed as being mechanoreceptory, rather than being discrete neurophysiological (...) systems which evolved independently of each other. I go on to argue that this idea could potentially explain language evolution, with birdsong being an example of a more simple form of non-Saussurean language that employs ‘frequency-mimicking’ to produce a vocal signal which describes acoustic, chemical and electromagnetic vibrational frequencies detected within in the environment. I also give examples of how this hypothesis could potentially explain phenomena such as vocal mimicry in animals, as well as the human perception of musicality and the occurrence of synaesthesia; a condition found in humans, where the stimulation of one sensory modality results in the stimulation of another. For example, auditory stimuli are detected and are heard as an acoustic signal, as well as being perceived as colour by the visual system. (shrink)

How does propaganda differ from the legitimate persuasive practices that animate a healthy democracy? The question is especially salient as digital technologies facilitate new modes of political persuasion and the public square saturates with information factual and fabricated alike. In answer, we propose a typology based on the rhetorical strategies that propaganda and its legitimate counterpart each employ. We argue that the point of contrast between the phenomena turns on two key features: whether the rhetorical strategy sufficiently engages our deliberative (...) capacities, and whether it runs counter to our epistemic interests. While in practice the boundary between the concepts is not always sharp, the account identifies a set of conceptual tools that help better frame and come to grips with propaganda and legitimate political persuasion in an information-dense and increasingly complex media landscape. (shrink)

Morally speaking, what should one do when one is morally uncertain? Call this the Moral Uncertainty Question. In this paper, I argue that a non-ideal moral theory provides the best answer to the Moral Uncertainty Question. I begin by arguing for a strong ought-implies-can principle---morally ought implies agentially can---and use that principle to clarify the structure of a compelling non-ideal moral theory. I then describe the ways in which one's moral uncertainty affects one's moral prescriptions: moral uncertainty constrains the set (...) of moral prescriptions one is subject to, and at the same time generates new non-ideal moral reasons for action. I end by surveying the problems that plague alternative answers to the Moral Uncertainty Question, and show that my preferred answer avoids most of those problems. (shrink)

BackgroundBioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do so, these conversations also need to reflect on the issue of diversity within the field of bioethics across the globe. This study aims to examine current gender representation and diversity at medical ethics and humanities institutes in Germany, the German-speaking areas of Switzerland, and Austria.MethodsA total of (...) forty-nine medical ethics and humanities institutes from Germany (n=42), the German-speaking areas of Switzerland (n=5), and Austria (n=2) were included in the study. Institutes websites were reviewed in the first week of March 2021 and the details of each staff member listed on the website recorded.ResultsOverall, a total of 964 staff members were identified at the forty-nine German-speaking medical ethics and humanities institutes. Just over half (530/964; 55%) of all staff were female. There were significant differences between gender in some staff positions: 64.6 per cent (31/48) of directors were male (χ2(1)=4.1, P=.04); 62.7 per cent (84/134) of student assistants were female (χ2(1)=8.6, P=.003); and 83.7 per cent (77/92) of administrative staff were female (χ2(1)=41.8, P<.001). There were no significant differences between staff gender for researchers and lecturers, or associated researchers. In addition, 65.5 per cent (19/29) of researchers and lecturers who had a professor title were male, but the difference between genders was not found to be significant. However, significantly more of the researchers and lecturers who had completed a habilitation were male (75.8% (25/33); χ2(1)=8.8, P=.003). When comparing the institute director’s gender presentation with staff gender presentation, it was found that male-led institutes had 53.4 per cent (286/536) female staff overall but had 52.7 per cent (136/258) male researchers and lecturers. However, the difference between genders were not found to be significant. On the other hand, female-led institutes had significantly more female staff overall (59.9% (223/372); χ2(1)=14.7, P<.001) and also significantly more female researchers and lecturers (58.9% (119/202; χ2(1)=6.4, P=.01).ConclusionsThere has been a significant push to address gender diversity in German-speaking academia, and this study finds overall good gender parity in medical ethics and humanities institutes. However, there has not been a similar openness to discussing issues of systemic racism or how other forms of inequality affect academic diversity. Taking diversity seriously requires opening up conversations around intersectionality, including difficult conversations around race and cultural background that have long been taboo in German-speaking countries. (shrink)

The field of artificial intelligence (AI) ethics has exploded in recent years, with countless academics, organizations, and influencers rushing to consider how AI technology can be developed and im...

This essay considers the ways in which graphic caregiving memoirs complicate the idealizing tendencies of ethics of care philosophy. The medium’s “capacious” layering of words, images, temporalities, and perspectives produces “productive tensions... The words and images entwine, but never synthesize”. In graphic memoirs about care, this “capaciousness” allows for quick oscillation between the rewards and struggles of care work, representing ambiguous, even ambivalent attitudes toward care. Graphic memoirs effectively represent multiple perspectives without synthesis, part of a structural and thematic ambivalence (...) that provides a provocative counterpart to the abstract idealism of ethics of care philosophy. (shrink)

This paper considers three possible ways of understanding the claim that the American criminal justice system is racist: individualist, “patterns”-based, and ideology-based theories of institutional racism. It rejects an individualist explanation of institutional racism because such an explanation fails to explain the widespread prevalence of anti-black racism in this system or indeed in the United States. It considers a “patterns” account of institutional racism, where consistent patterns of disparate racial effect mimic the structure of intentional projects of racial subjugation like (...) slavery or Jim Crow. While a “patterns” account helpfully directs attention to the effects of policies and practices that make up an institution, it does not fully explain the deep roots of anti-blackness in the criminal justice system in the United States. The paper concludes by defending an ideology-based theory of institutional racism for understanding the criminal justice system because the stereotype of the black criminal has a mutually reinforcing relationship with the patterns of disparate outcome for black people in the criminal justice system. This relationship creates a looping effect where the stereotype of the black criminal fuels the disproportionate involvement of black people in the criminal justice system, and the disproportionate representation of black people with felony records, in prisons, brutalized in police encounters, and so on reinforces the idea that black people are especially prone to criminality. Ideological approaches to racism that integrate attention to the patterns of disparate effect best explain what it means to say that the criminal justice system is racist. (shrink)

Sensory augmentation challenges current societal norms and views of what is conceived as a “normal” human being. Beginning with self reflections of a bodyhacker, the author proposes an extended view onto the human or respectively cyborg body. Based on cognitive theories, it is argumented that we are already mental cyborgs. Our brains plastically restructure themselves in order to meet new requirements of the technological extended human.

Several philosophers have recently argued that decision-theoretic frameworks for rational choice under risk fail to provide prescriptions for choice in cases of moral uncertainty. They conclude that there are no rational norms that are “sensitive” to a decision maker’s moral uncertainty. But this chapter argues that one sometimes has a rational obligation to take one’s moral uncertainty into account in the course of moral deliberation. It first provides positive motivation for the view that one’s moral beliefs can affect what it (...) is rational for one to choose. It then addresses the problem of value comparison, according to which one cannot determine the expected moral value of one’s actions. The chapter argues that we should not infer from the problem of value comparison that there are no rational norms governing choice under moral uncertainty. (shrink)

RESUMO: Os intérpretes dos manuscritos de Leonardo da Vinci partilham dos mesmos sentimentos de espanto e de fascínio quando examinam sua contribuição para a ciência moderna. Podemos, contudo, perceber uma constante tentativa em prol de uma revisão histórica acerca do papel desempenhado por Leonardo. Observando a história dessas revisões, é possível detectar aspectos significativos das perspectivas históricas e historiográficas dos envolvidos nessa discussão. É o que pretendemos fazer neste trabalho, focando a controvérsia entre Duhem, por um lado, e Sarton, Koyré (...) e Rossi, por outro. Ao fazer isso, buscamos discutir alguns traços que marcam a distinção entre uma historiografia mais antiga e a nova historiografia da ciência, tal como exposta por Thomas Kuhn. ABSTRACT: Interpreters of Leonardo da Vinci's manuscripts share the same feelings of astonishment and fascination when they examine his contribution to modern science. However, it is possible to perceive an ongoing attempt towards a historical revision of the role played by Leonardo. Observing the history of this ongoing revision, it is possible to detect significant aspects of the historical and historiographical perspectives of those involved in this discussion. This article deals with the controversy between Duhem's point of view, on the one hand, and the views of Sarton, Koyré, and Rossi on the other. It aims to show some features that distinguish an older historiography from the new historiography of science as presented by Thomas Kuhn. (shrink)

In this paper, I examine the way humans interact with domestic companion animals, with a focus on ‘positive reward-based training’ methods, particularly for dogs. From a biosemiotic perspective, I discuss the role of animal training in today’s society and examine what binary reward- based reinforcement schedules communicate, semiotically. I also examine the extent to which reward-based training methods promote better welfare, when compared to the more traditional methods which rely on aversive stimuli and punishment, if and when they are relied (...) upon excessively. I conclude that when used as the primary means of communication, they have the potential to be detrimental to animal welfare, because the underlying social signal is control and resource dominance. As an alternative view to behaviourist-based learning theory and conditioning, I outline how enactivist theories of cognition support a semiotic approach to interspecific human-animal communication. I therefore propose a move toward a dynamic semiosis and mutual understanding based upon Peirce’s phenomenology, resulting in a more balanced merging of Umwelten. The aim is to create rich and more complex semiospheres around humans and domestic animals, which allow for individual agency and autonomy. (shrink)

Legal professionals in Malawi rely on a limited number of textbooks, outdated law reports and inadequate library services. Most documents available are in image form, are un-structured, i.e. contain no useful legal meta-data, summaries, keynotes, and do not support a system of citation that is essential to legal research. While advances in document processing and machine learning have benefited many fields, legal research is still only marginally affected. In this interdisciplinary research, the authors build semi-automatic tools for creating a corpus (...) of Malawi criminal law decisions annotated with legal meta-data, case and law citations. We used this corpus to extract legal meta-data, including law and case citations as used in Malawi by employing machine learning tools, spaCy and Gensim LDA. We set the foundation for a new methodology for classifying Malawi criminal case law according to the recently introduced International Classification of Crime for Statistical Purposes (ICCS). (shrink)

There are cases in which, intuitively, an agent’s action is both morally right in one sense, and morally wrong in another sense. Such cases (along with other intuitions about blameless wrongdoing and action-guidance) support distinguishing between the objective moral ‘ought’ and the subjective moral ‘ought.’ This chapter argues against drawing this distinction, on the grounds that the prescriptions delivered by an adequate objective moral theory must be sensitive to the mental states of agents. Specifically, an adequate theory of the objective (...) moral ‘ought’ must respect a strong ought-implies-can principle—morally ought implies agentially can—in order to prescribe actions to real-life agents. An agent’s mental states determine what is agentially possible for that agent; thus, what an agent objectively morally ought to do is in part determined by the agent’s mental states. This chapter describes the structure of a compelling non-ideal moral theory that is both objective and mental state-sensitive. This non-ideal theory illuminates the shortcomings of extant objectivist and subjectivist moral theories, and illustrates how we can dispense with the subjective moral ‘ought.’. (shrink)

Sean McKeever and Michael Ridge object that moral particularism ‘flattens the moral landscape’, that is, that particularism treats reasons of different kinds as if they were reasons of the same kind. This objection is misguided in two respects. First, particularists need not say that every feature can be a moral reason. Second, even if particularists were committed to saying that every feature can be a moral reason, they would still not be committed to the view that every feature can have (...) direct moral relevance. The failure of this objection shows that the objection exploits side-constraints that need not be placed on moral particularism. (shrink)

Hugh Baxter’s book Habermas: A Discourse Theory of Law and Democracy not only carefully recounts Habermas’ political and legal theory, but also raises several insightful criticisms of Habermas. Of particular note is Baxter’s criticism of Habermas’ system–lifeworld model originally presented in Theory of Communicative Action. Baxter argues that Habermas ought to discard the concept of the lifeworld because the distinction between lifeworld and system is no longer tenable in the model of political power presented in Habermas’ later work, Between Facts (...) and Norms, which focuses more explicitly on law as a social system. Baxter contends that the lifeworld, which Habermas describes as those parts of our lives that are structured by communicative action and shared norms, is an unhelpful way of understanding our social world because, in reality, most of our interactions are structured both by communicative norms and by the strategic action typical of ‘the system’. I argue, however, that Habermas must retain the theoretical distinction between system and lifeworld, though in everyday practice they are not so neatly disentangled, because without such an element there would be no source of legitimacy for the law. Without a connection to the communicative action of the lifeworld, law and the political structure would be nothing but strategic action. (shrink)

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)