Securitization is considered to be one of the biggest financial innovations of the last century. It is also regarded as both a catalyst and a solution to the 2008 financial crisis. Once a popular method of financing the mortgage and consumer credit markets, aspects of the global securitization market are now struggling to revive. In this paper, I discuss the role that ethics played in securitization prior to the 2008 financial crisis and find that it is not an obvious story (...) of moral failures, but rather that it lies in more subtle elements of the financial system. The ethics uncertainty role in the securitization story is one of flawed incentives and the shifting of responsibility for handling risk. The role of securitization and the ethics of risk transfer have rarely been discussed explicitly in the literature. The historical origins of securitization and lessons learned from previous flawed uses of the process are also provided. I also detail the various global institutional reform proposals that have taken place. Moving forward, it is crucial to understand the causes, consequences, and ethical implications of securitization in the financial crisis so as to help individuals and managers better assess risk, align incentives, and design appropriate policy responses. (shrink)

Natalie Zemon Davis’s work has decentered the identities of her subjects as part of seeing their complexity. This essay, inspired by Davis’s rich thought and scholarship, looks at the ways in which the Romantics in the arts decentered their thought and practices away from the West. Their decentering involved serious study of non-Western thought and its incorporation into their art, and the regular use of opium to shape their creative works. One borrowed theme was transcendence to a higher mode of (...) existence, often through sexual union with a woman. So influential did Romantic tropes, themes, and images derived from outside the West become that they persisted in Western culture long after the Romantics themselves had lost interest in the body of non-Western culture from which they drew. Examples include the work of Samuel Coleridge, Walter Scott, Hector Berlioz, the Schlegel brothers, Caroline Günderode, Sidney Owenson, and others. (shrink)

This is an innovative introduction to the issues of contemporary feminism, with a truly global perspective. It analyses the roots, development, and, in some cases, the conclusions of feminisms and how they have interacted.

Jusqu’à une époque récente la recherche occidentale sur l’histoire des femmes s’est presque exclusivement intéressée à l’Europe et aux États-Unis. Ailleurs dans le monde, l’intérêt porté à la condition des femmes était aussi centré sur le niveau local ou national. L’histoire des États-nations a servi de cadre aux innombrables découvertes des chercheurs. Mais aujourd’hui, l’histoire des femmes s’est enrichie d’autres dimensions d’analyse, notamment du concept de genre et d’une ouverture sur le monde. Cette étude trace l’évolution de l’histoire des femmes (...) et du genre dans son rapport avec la New World History. À partir de quelques exemples récents, nous montrons aussi comment l’histoire mondiale réoriente les études dans le domaine de l’histoire des femmes et de du genre. (shrink)

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

: Recent controversial decisions to terminate several large clinical trials have called attention to the need for developing a sound ethical framework to determine when trials should be stopped in light of emerging efficacy data. Currently, the fundamental rationale for stopping trials early is based on the principle that equipoise has been disturbed. We present an analysis of the ethical and practical problems with the "equipoise disturbed" position and describe an alternative ethical framework based on the principle of nonexploitation. This (...) framework acknowledges the need for balancing the dual ethical obligations of clinical research, the protection of human subjects and the generation of new medical knowledge. Based on this framework, we put forward a proposal to make early stopping guidelines more stringent under specified conditions. The temporary withholding of apparent benefits in certain circumstances is justified by achieving a fair contract with the research participants, one that protects them from undue harm and exploitation while reducing the many uncertainties surrounding new investigational treatments that arise when trials are stopped prematurely. (shrink)

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

Our society has long sanctioned, at least tacitly, a degree of conflict of interest in medical practice and clinical research as an unavoidable consequence of the different interests of the physician or clinical investigator, the patient or clinical research subject, third party payers or research sponsors, the government, and society as a whole, to name a few. In the past, resolution of these conflicts has been left to the conscience of the individual physician or clinical investigator and to professional organizations. (...) The public is no longer willing to allow health care providers to wholly govern their own conflicts of interest for several reasons. These include: new forms of health care financing and delivery that provide innovative and lucrative opportunities for physician or insurer enrichment at patient expense; the increased importance of commercial research support as peer-reviewed governmental research support has decreased; evidence that physicians and clinical investigators too frequently resolve conflicts of interest in their own favor; and a general societal mistrust of authority. This volume represents a multidisciplinary effort, drawing from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research, and, where possible, to offer a mechanism for resolving them. Part I addresses conflicts of interest from a theoretical perspective, offering basic concepts and analytical frameworks. The second part discusses two topics prominent in current health care policy debates--self-referral and financial incentives to limit care. Part III examines conflicts of interest generated by pharmaceutical industry involvement in clinical practice and research. The final section deals with conflicts of interest in clinical research in several contexts, including institutional reviews boards, clinical trials, Cooperative Research and Development Agreements between government and private researchers, brokerage of research subjects by Contract Research Organizations, and cost-effectiveness studies. (shrink)

Recent work in artificial intelligence, or AI, has produced programs capable of serious intellectual work in science. Results from AI are used to show that there exist mechanized procedures for discovering hypotheses and that these methods often lead to plausible hypotheses. The question to be answered is: By what methods can a computer program find plausible explanations of empirical data? To answer this, the common metaphor of search for describing several AI programs is examined followed by a look at examples (...) of programs actually constructed. Five types of search considered are: random, exhaustive, selective, heuristic, and opportunistic search. From there, the paper generalizes to some conclusions about mechanizing hypothesis formation. (shrink)

The prelims comprise: Introduction Historical Background The Role of Health Research in Promoting Social Justice Justice in Setting Research Priorities Justice Concerns within the Research Context Case Study: The Investigation of Alternative Lead Abatement Procedures by the Kennedy Krieger Institute Conclusion Note References.

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)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

A letter to the editor from Howard Brody, David Buchanan, and Franklin G. Miller in response to the recent article by Erik Malmqvist Understanding Exploitation," March-April 2011).

This article reviews the strengths and limitations of five major paradigms of medical computer-assisted decision making (CADM): (1) clinical algorithms, (2) statistical analysis of collections of patient data, (3) mathematical models of physical processes, (4) decision analysis, and (5) symbolic reasoning or artificial intelligence (Al). No one technique is best for all applications, and there is recent promising work which combines two or more established techniques. We emphasize both the inherent power of symbolic reasoning and the promise of artificial intelligence (...) and the other techniques to complement each other. (shrink)

This paper begins with a question: can concepts generated in the Chinese context in the sociocultural relations of the periphery contribute to the development of the social sciences in the field of Health and Physical Education (HPE) that have their roots in the metropole? Setting the scene in the Hong Kong Special Administrative Region (HKSAR), a postcolonial city reverted to the rule of the People’s Republic of China (PRC) in 1997, this paper aims to develop a critical sociology of HPE (...) by having a dialogue among Continental philosophies (e.g., Bourdieu) and Chinese philosophies around embodiment concepts. Although HKSAR is a complex meeting point of Eastern and Western ideologies, the current HPE field tends to focus on Western and ‘scientific’ ways of knowing, such as the measurement of health and physical fitness, and often at the expense of sociocultural perspectives, social justice and diversity and inclusion in HPE. In other words, the (post) positivistic research paradigm underpins the HPE field. This paper argues that in order to reap the benefits of a more holistic health education for academics and students in HPE, it is vital to de-imperialise the positivistic ways of teaching and being in HPE. In doing so, this paper creates a space for Bourdieu’s habitus to meet Chinese perspectives on embodiment to engage in a dialogue for knowledge production that extends the current knowledge base in HPE. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Brian Loar [1976] observed that, even in the simplest of cases, such as an utterance of (1): ‘He is a stockbroker’, a speaker's audience might misunderstand her utterance even if they correctly identify the referent of the relevant singular term, and understand what is being predicated of it. Numerous theorists, including Bezuidenhout [1997], Heck [1995], Paul [1999], and Récanati [1993, 1995], have used Loar's observation to argue against direct reference accounts of assertoric content and communication, maintaining that, even in these (...) simple cases, the propositional contribution of a referring expression must be more than just its referent. -/- I argue here that, while Loar's observation is correct, the conclusion he and others have sought to draw from it simply does not follow. Rather, his observation helps to remind us of an important Gricean insight into the nature of communicative acts—including acts of speaker-reference—namely, that there is more to understanding a communicative act than merely entertaining what a speaker is intending to communicate thereby. Once we remember this insight, we see that the phenomenon to which Loar is calling our attention should actually be expected given the direct reference theorist's assumptions, together with independently plausible Gricean principles concerning how we make our referential intentions manifest in communication. More generally, the Gricean strategy for explaining the challenge posed by Loar cases suggests a novel way to account for certain crucial anti-direct reference intuitions—one requiring no modification of the original theory (e.g., no invocation of ‘descriptive enrichments’ as in Soames [2002]), thereby allowing for a direct reference account of what is asserted in utterances of ‘simple sentences’ such as (1). (shrink)