In this paper we consider the use of cases in medical ethics research and teaching. To date, there has been little discussion about the consent or confidentiality requirements that ought to govern the use of cases in these areas. This is in marked contrast to the requirements for consent to publish cases in clinical journals, or to use personal information in research. There are a number of reasons why it might be difficult to obtain consent to use cases in ethics. (...) Many cases concern people who are incompetent, and thus unable to give consent. Often the material is of a sensitive nature, it is not clear who should give consent, or the ethicist has no access to those involved. We argue that the use of cases in ethics research and teaching can be justified by appeal to the public interest argument, and suggest a number of areas for discussion and clarification. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

That being than which a greater cannot be conceived.' This was the way in which the living God of biblical tradition was described by the great Medieval philosophers such as Augustine, Anselm and Aquinas.Contemporary philosophers find much to question, criticise and reject in the traditional analysis of that description. Some hold that the attributes traditionally ascribed to God - simplicity, necessity, immutability, eternity, omniscience, omnipotence, creativity and goodness - are inherently incoherent individually, or mutually inconsistent. Others argue that the divinity (...) described by philosophers cannot be the same as the providential God of revelation.In Perfect Being Theology Katherin A. Rogers defends the traditional approach, considering contemporary criticisms but concluding that the most adequate account of the nature of God should build upon the foundation laid by the Medieval philosophers.Written in a lively and accessible style and offering an important historical perspective, this book covers key areas of contention and many of the major ideas and thinkers from all sides of the debate are included. (shrink)

This paper argues that, in addition to humanitarian concerns, policies toward immigrants should also be shaped by recognition of special responsibilities toward some populations of noncitizens. National governments acquire such responsibilities in part through their histories of coercive impositions on those populations. Former imperial powers, in particular, often possess special obligations toward the inhabitants of their foreign colonies that go beyond their general humanitarian responsibilities. Those obligations might be met in various ways; but if national governments of wealthy, formerly imperial (...) states granted greater access for immigration to the poor of their former colonies, migration flows might significantly contribute to reductions in global levels of inequality. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

Americans have always been divided over whether to welcome or to discourage immigration. But virtually all American leaders have rested their views on notions that the United States has unique providential or world-historical significance-as an asylum for the world's oppressed, as a model to the world, or even as the world's leader. Today, it is normatively desirable for the U.S. to view itself not as the world's "city on a hill" but simply as one worthy political society among many others. (...) Whether such a view can be made politically appealing to most Americans, however, remains in doubt. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

If within the borders of human life the truth is, as Vico has said, what is made, then the task of a student of human life can be and should be to find out from what human beings have made what manner of makers they are and what sorts of production their circumstance allows.

It is a commonplace to observe that we have been living through an extraordinary pan-European and trans-Atlantic populist moment. But do the heterogeneous phenomena lumped under the rubric “populist” in fact belong together? Or is “populism” just a journalistic cliché and political epithet? In the first part of the article, I defend the use of “populism” as an analytic category and the characterization of the last few years as a “populist moment,” and I propose an account of populism as a (...) discursive and stylistic repertoire. In the second part, I specify the structural trends and the conjunctural convergence of a series of crises that jointly explain the clustering in space and time that constitutes the populist moment. The question in my title is thus twofold: it is a question about populism as a term or concept and a question about populism as a phenomenon in the world. The article addresses both the conceptual and the explanatory question, limiting the scope of the explanatory argument to the pan-European and trans-Atlantic populist conjuncture of the last few years. (shrink)

ABSTRACT Few denials of tolerance are more severe than rejection of the moral worth of another’s way of life. In the U.S. today, many traditional religious believers, especially fundamentalist Christians, and many LGBQT+ persons see each other’s ways of life as deeply evil in important respects. These gulfs probably cannot be bridged; but public policies can and should seek to accommodate all claims of conscience as far as this can be done without denying anyone meaningful possession of basic rights. By (...) placing religious and moral consciences equally in a constitutionally “preferred position,” governments can foster a wider sense that citizens are engaged in a shared enterprise of helping everyone to pursue their distinctive forms of happiness. (shrink)

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...) those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases. (shrink)

According to David Hume our idea of a necessary connection between what we call cause and effect is produced when repeated observation of the conjunction of two events determines the mind to consider one upon the appearance of the other. No matter how we interpret Hume's theory of causation this explanation of the genesis of the idea of necessity is fraught with difficulty. I hope to show, looking at the three major interpretations of Hume's causal theory, that his account is (...) contradictory, plainly wrong, or inherently impossible to verify. (shrink)

Determining whether a person who appears to have committed an offence should then be prosecuted for it requires a number of assessments and weighing of interests. Yet, to read the latest Code for Crown Prosecutors, one would think that the exercise of prosecutorial discretion is a relatively unstructured process. This is because the Code does not require prosecutors to identify an aim in seeking the punishment of the accused, and because it does not distinguish between the harms caused to the (...) defendant by punishment and the distinct harms which are caused to him by prosecution. I shall argue that the aim of the prosecutor (assuming that guilt will be proven) should be to decide whether the aims of punishment of the accused would be justified by the likely costs of the proceedings, but that this aim may be constrained by considering the harms which may be caused to the defendant by prosecution. If this structure were to be accepted, then it would both be easier to draft a Code for Crown Prosecutors which has useful guiding value and to identify to whom the prosecutor should be accountable for his decisions. (shrink)

Marriagelike homosexual relationships expose a division among ethicists following Aquinas. Those emphasizing natural law may call such relationships unnatural; those emphasizing the virtues may approve of relationships fostering love and justice. Natural law, the virtues, and homosexuality all show up in Aquinas's "Commentary on Romans"--untranslated and hardly cited. Romans 1:18 opens a discussion of justice. Verse 20 provides Aquinas's chief warrant for natural law. Verse 26 applies virtue and law to "the vice against nature." But Aquinas's account also depends on (...) Paul as an exemplar of virtue and on Aquinas's high regard for the Bible. Aquinas deploys natural law as a mode of biblical exegesis, not an alternative to it. In the "De potentia", Aquinas considers how to proceed when nature and Scripture seem to conflict. The account does not settle, but rather makes more room for, dispute. (shrink)

Many health care systems include programs that allow patients in exceptional circumstances to access medical interventions of as yet unproven benefit. In this article we consider the ethical justifications for—and demands on—these special access programs (SAPs). SAPs have a compassionate basis: They give patients with limited options the opportunity to try interventions that are not yet approved by standard regulatory processes. But while they signal that health care systems can and will respond to individual suffering, SAPs have several disadvantages, including (...) the potential to undermine regulatory and knowledge-generation structures that constitute significant public goods. The “balance” between these considerations depends in part on how broadly SAPs are used, but also on whether SAPs can be made to contribute to the generation of knowledge about the effects of health interventions. We argue that patients should usually be required to contribute outcome data while using SAPs. (shrink)

In this prcis we focus on phenomena central to the reaction against similarity-based theories that arose in the 1980s and that subsequently motivated the approach to semantic knowledge. Specifically, we consider (1) how concepts differentiate in early development, (2) why some groupings of items seem to form or coherent categories while others do not, (3) why different properties seem central or important to different concepts, (4) why children and adults sometimes attest to beliefs that seem to contradict their direct experience, (...) (5) how concepts reorganize between the ages of 4 and 10, and (6) the relationship between causal knowledge and semantic knowledge. The explanations our theory offers for these phenomena are illustrated with reference to a simple feed-forward connectionist model. The relationships between this simple model, the broader theory, and more general issues in cognitive science are discussed. (shrink)

The Oxford Handbook of the Economics of Networks represents the frontier of research into how and why networks they form, how they influence behavior, how they help govern outcomes in an interactive world, and how they shape collective decision making, opinion formation, and diffusion dynamics. From a methodological perspective, the contributors to this volume devote attention to theory, field experiments, laboratory experiments, and econometrics. Theoretical work in network formation, games played on networks, repeated games, and the interaction between linking and (...) behavior is synthesized. A number of chapters are devoted to studying social process mediated by networks. Topics here include opinion formation, diffusion of information and disease, and learning. There are also chapters devoted to financial contagion and systemic risk, motivated in part by the recent financial crises. Another section discusses communities, with applications including social trust, favor exchange, and social collateral; the importance of communities for migration patterns; and the role that networks and communities play in the labor market. A prominent role of networks, from an economic perspective, is that they mediate trade. Several chapters cover bilateral trade in networks, strategic intermediation, and the role of networks in international trade. Contributions discuss as well the role of networks for organizations. On the one hand, one chapter discusses the role of networks for the performance of organizations, while two other chapters discuss managing networks of consumers and pricing in the presence of network-based spillovers. Finally, the authors discuss the internet as a network with attention to the issue of net neutrality. (shrink)