Anna Chavlovski,1 Greg A Knoll,1–3 Timothy Ramsay,4 Swapnil Hiremath,1–3 Deborah L Zimmerman1–31University of Ottawa, 2Ottawa Hospital, 3Kidney Research Centre, Ottawa Hospital Research Institute, 4Ottawa Methods Centre, Ottawa, ON, CanadaBackground: In patients with end-stage renal disease, use of vitamin D and calcium-based phosphate binders have been associated with progression of vascular calcification that might have an impact on renal transplant candidacy. Our objective was to examine management of mineral metabolism in patients wait-listed for renal transplant and to determine the impact (...) on cardiac perfusion imaging.Methods: Data was collected retrospectively on patients wait-listed for a renal transplant, being either active and on hold. Demographic data, medications, serum concentrations of calcium, phosphate, parathyroid hormone, and cardiac perfusion imaging studies were collected from the electronic health record. Chi-square and Student’s t-tests were used to compare active and on-hold patients as appropriate. Logistic regression was used to examine variables associated with worsening cardiac imaging studies.Results: The wait-listed patients were of mean age 56 ± 14 years and had been on dialysis for 1329 ± 867 days. On-hold patients had received a significantly greater total dose of calcium and were more likely to have developed worsening cardiovascular imaging studies. Total doses of calcium and calcitriol were associated with worsening cardiovascular imaging studies.Conclusion: Patients on hold on the renal transplant waiting list received higher total doses of calcium. A higher total dose of calcium and calcitriol was also associated with worsening cardiovascular imaging. Time on dialysis before transplant has been associated with worse post-transplant outcomes, and it is possible that the total calcium and calcitriol dose received contributed to these inferior outcomes.Keywords: dialysis, calcium, cardiac, transplantation. (shrink)
Leisure activities account for much of our time - and money. But are contemporary forms of leisure good for us? Are they really leisure? And how much does (and should) leisure matter? Classical philosophers paid attention to these questions. Increasingly, modern philosophers too are realizing the importance of leisure, and of a good leisure / work balance. Hayden Ramsay looks at the meaning of leisure, and the links between recreation, relaxation, virtue, and happiness. By focusing on leisure activities such (...) as sport, travel, music and reading, Ramsay explores the need for good play in a good life. (shrink)
The authors use empirical research into the environmental practices of 31 manufacturing small and medium-sized enterprises (SMEs) to show that ‚business performance’ and ‚regulation’ considerations drive behaviour. They suggest that this is inevitable, given the market-based decision-making frames that permeate and dominate the industry in which manufacturing SMEs operate. Since the environment is a pillar of corporate social responsibility (CSR), the findings have important implications for CSR policy, which promotes voluntary actions predicated on a business case. It is argued that (...) this approach will not alter the behaviour of manufacturing SMEs significantly because CSR practice will be regarded as an optional and costly ‚extra’ affecting core business activity. Consequently, the use and development of existing regulatory structures, providing minimum standards for many activities covered by CSR, remains the most effective means through which the behaviour of manufacturing SMEs will be changed in the short to medium-term. Another feature of the paper is the distinction made between ‚business performance’ and the ‚business case’ argument. Business performance emphasises cost reductions and efficiency whereas the business case accentuates the benefits to shareholders of good practices as their firms become more attractive to stakeholders and society. Manufacturing SMEs␣try to improve business performance because of the pressures placed on them by market-dominated decision-making frames. These frames do not encourage manufacturing SMEs to undertake voluntary actions for the benefit of wider stakeholders and society. (shrink)
Company–community agreements are widely considered to be a practical mechanism for recognising the rights, needs and priorities of peoples impacted by mining, for managing impacts and ensuring that mining-derived benefits are shared. The use and application of company–community agreements is increasing globally. Notwithstanding the utility of these agreements, the gender dimensions of agreement processes in mining have rarely been studied. Prior research on women and mining demonstrates that women are often more adversely impacted by mining than men, and face greater (...) challenges in accessing development opportunities that mining can bring. Nonetheless, there is currently little guidance for companies, government or communities in bringing a gender perspective to the fore in mining and agreement processes. It is undisputed in human development literature that investment in women and sensitivity to gender delivers long-term health, education and local development outcomes. In mining and development, a number of key factors remain unexplored. These include: women’s participation in agreement processes, the gendered distribution of agreement benefits, and the extent to which impacts and benefits influence women’s development and economic inclusion. This paper presents the results of the first phase of an applied research project undertaken by the Centre for Social Responsibility in Mining at The University of Queensland and funded by the Minerals Council of Australia and the Department of Foreign Affairs and Trade. The project sought to connect with experienced practitioners who had been directly involved in mining and agreement processes to document and analyse grounded perspectives on gender dynamics and agreements, and connect those experiences with the broader literature. Findings from this study have implications for the role of mining companies and governments in promoting gender equality and empowerment as part of their commitments to sustainable development. They also have implications for community groups and their representatives in terms of how they might engage in agreement processes to maximise women’s participation and influence. In many social contexts, a key challenge will be navigating the territory of cultural norms and gender equality, particularly in cultures where women’s influence in the public sphere is not strong. The authors argue that without consideration of a gender perspective, including gender’s intersection with other factors such as class, race, poverty level, ethnic group and age, mining agreements will not be inclusive, may exacerbate gender inequalities, and fail to contribute to long-term sustainable development. (shrink)
Some philosophers argue that, because it is subject to twinning and fusion, the early human embryo cannot hold strong moral standing. Supposedly, the fact that an early human embryo can twin or fuse with another embryo entails that it is not a distinct individual, thus precluding it from holding any level of moral standing. I argue that appeals to twinning and fusion fail to show that the early human embryo is not a distinct individual and that these appeals do not (...) provide us with plausible reasons for denying the strong moral standing of the early human embryo. I recognize one possible exception to this general assessment, a particular version of the appeal to fusion. Embryo fusion that results in tetragametic chimerism provides some reason for doubting the early human embryo's moral standing. But twinning and fusion are otherwise irrelevant in this context. (shrink)
What does philosophy have to say about the argument that blasphemous art ought not to be publicly displayed? We examine four concepts of blasphemy: blasphemy as offence, attack on religion, attack on the sacred, attack on the blasphemer himself. We argue all four are needed to grasp this complex concept. We also argue for blasphemy as primarily a moral, not a religious concept. We then criticise four arguments for the public display of blasphemous art: it may be beautiful, provocative, devoutly (...) intended, and is autonomous of religious concerns. Finally, we discuss the notions of blasphemy and blasphemous art as public offences. We conclude that the display of blasphemous art is a public, and not merely a private moral offence, and that there are respectable philosophical arguments for this conclusion. (shrink)
The Slogan holds that one situation cannot be worse (or better) than another unless there is someone for whom it is worse (or better). This principle appears to provide the basis for the levelling-down objection to teleological egalitarianism. Larry Temkin, however, argues that the Slogan is not a plausible moral ideal, since it stands against not just teleological egalitarianism, but also values such as freedom, rights, autonomy, virtue and desert. I argue that the Slogan is a plausible moral principle, one (...) that provides a suitable moral basis for the levelling-down objection to teleological egalitarianism. Contrary to Temkin, freedom, autonomy, virtue, and rights can all be understood in person-affecting terms, while equality of outcome cannot. Moreover, the Slogan is open to a variety of different ideas about how we should weight or rank people's gains and losses. This flexibility allows the Slogan to accommodate ideals such as prioritarianism and desert. (shrink)
The paper presents Aquinas’s account of conscience, and argues that key elements of this account are key elements too of Aristotle’s moral theory. The paper’s purpose is to encourage debate over conscience as not only a Stoic/Christian concept but one with deeper— and more widespread—roots in western ethical tradition.
In this paper, we discuss the ethical responsibility of the Information Technology (IT) industry towards its female workforce. Although the growing IT industry experiences skills shortages, there is a declining trend in the representation of women. The paper presents evidence that the IT industry is not gender-neutral and that it does little to promote or retain its female workforce. We urge that professional codes of ethics in IT should be revised to take into account the diverse needs of its staff.
Rawls's burdens of judgment are a list of factors that explain why reasonable persons in a diverse society are likely to hold different, often incompatible, conceptions of the good. According to Charles Larmore, the burdens of judgment satisfy political liberalism's ambition of supporting liberal political principles through a minimalist moral conception. By using the burdens, we ground liberal politics in the modest notion of reasonable disagreement, avoiding reliance on controversial comprehensive notions such as autonomy, individuality, skepticism about the good, or (...) value pluralism. In this paper I argue that the burdens of judgment cannot provide adequate support for liberal political principles unless they are read in a way that comports with Kymlicka's modest version of autonomy liberalism. As it renounces fallibilism, political liberalism's moral minimalism can be manipulated in a way that reconciles it with decidedly illiberal results. The only way to avoid this problem is to recognize that the justification of liberal principles cannot be detached from notions of fallibilism and critical reflection about the good. Ultimately, political liberalism's emphasis on moral minimalism deprives it of the conceptual resources it needs to deal with contemporary controversies concerning the defence and clarification of liberal policies. (shrink)
We consider two issues relating to WH-questions:(i) when you ask aWH-question you already have a description of the entity you are interested in,namely the description embodied in the question itself. You may evenhave very direct access to the entity – see (1) below.In general, what you want is an alternative description of some item thatyou already know a certain amount about.
The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We close (...) with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies. (shrink)
Conceptions of desert and responsibility have had a powerful influence in justifying economic inequality. Currently, they are being reaffirmed in policies advocated by the centre left in Britain. In contrast, luck egalitarianism, one of the dominant theoretical positions in contemporary political philosophy, puts equality at the top of the agenda and notoriously undermines traditional notions of desert and rejects the conception of personal responsibility on which traditional ideas rely. Although luck egalitarians are sceptical about desert and redefine responsibility to reduce (...) its role in arguments for just distribution, they nevertheless retain a commitment to holding people responsible for the distributive consequences of what they freely choose to do. They attempt to demonstrate that equality can be reconciled with responsibility. I will argue that luck egalitarians have not gone far enough in eliminating desert and responsibility from the armoury of social justice, and that their own arguments should have led them to do so. My aim in this article is to push the ideas implicit in luck egalitarian's arguments to their logical conclusion. I argue that for practical and conceptual reasons, they should have formulated their theories as though hard determinism is true, or nearly true, even if it is not. Denying the pertinence of judgements of desert and responsibility to questions of distributive justice removes an obstacle to egalitarian aims by suggesting a more egalitarian distribution than one that is hostage to voluntary choice. It could be accepted that luck egalitarianism cannot accommodate the concept of personal responsibility without accepting the conclusion that considerations of responsibility should be abandoned. However, any plausible account of responsibility would demonstrate that existing inequalities are undeserved, and that these inequalities make a mockery of politicans current emphasis on personal responsibility. (shrink)