The silencing of the epistemologies, theories, principles, values, concepts and experiences of the global South constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic and endangers the credibility of the entire field. As a first step towards reorienting the field, this paper offers a comprehensive account of epistemic justice for global health ethics. We (...) first introduce several different conceptions of justice and decolonisation in relation to knowledge, purposefully drawing on work emanating from the global South as well as the global North. We then apply those conceptions to the global health ethics context to generate a tripartite account of the layers of epistemic justice in the field: who is producing ethics knowledge; what theories and concepts are being applied to produce ethics knowledge; and whose voices are sought, recorded and used to generate ethics knowledge. These layers reflect that the field spans conceptual and empirical research. We conclude by proposing that, going forward, three avenues are key to achieve greater epistemic justice at each layer and to help decolonise global health ethics: namely, understanding the problem, dialogue and structural change. (shrink)

The current international healthcare focus on ensuring the perspectives and needs of individual persons, families or communities are met has led to the core tenet of person‐centred care for all. The nurse–patient relationship is central to the provision of care, and enhancing this relationship to ensure trust and respect supports optimal care outcomes for those accessing healthcare services. Engaging authentically is one of the recognised key approaches in person‐centred practice, and this scoping review of the literature aims to gain an (...) understanding of the role this process plays in developing effective relationships between nurses and the people they care for. A systematic search of databases and grey literature was undertaken, and twenty‐one research papers met the inclusion criteria. A thematic analysis revealed four themes: ‘getting to know the patient as a person’, ‘the complexity of relationship building—it takes time’, ‘the nurse: characteristics and behaviours that support the nurse–patient relationship’ and ‘the patient voice’. Nurses and patients both benefit from effective relationships, feeling valued and experiencing greater satisfaction with care. Key elements of engaging authentically were revealed as a nurse–patient relational process through this literature review; however, further research is needed to gain a greater understanding of this concept. (shrink)

Several authors have suggested that a more parsimonious and conceptually elegant treatment of everyday mereological and topological reasoning can be obtained by adopting a spatial ontology in which regions, not points, are the primitive entities. This paper challenges this suggestion for mereotopological reasoning in two-dimensional space. Our strategy is to define a mereotopological language together with a familiar, point-based interpretation. It is proposed that, to be practically useful, any alternative region-based spatial ontology must support the same sentences in our language (...) as this familiar interpretation. This proposal has the merit of transforming a vague, open-ended question about ontologies for practical mereotopological reasoning into a precise question in model theory. We show that (a version of) the familiar interpretation is countable and atomic, and therefore prime. We conclude that useful alternative ontologies of the plane are, if anything, less parsimonious than the one which they are supposed to replace. (shrink)

We are in the midst of a global crisis of climate change and environmental degradation to which the healthcare sector directly contributes. Yet conceptions of health justice have little to say about the environment. They purport societies should ensure adequate health for their populations but fail to require doing so in ways that avoid environmental harm or injustice. We need to expand our understanding of health justice to consider the environment and do so without reinforcing the epistemic injustice inherent in (...) the field of bioethics. This paper considers what work in philosophy related to the environment should be applied to help build that understanding and develops ideas about the healthcare sector’s responsibilities of justice to the environment. It first introduces the dominant multivalent environmental and ecological justice (EJ) concept in philosophy and each of its dimensions: distribution, participation, recognition and well-being. It then shows why applying that conception alone to broaden our understanding of health justice will reinforce epistemic injustice within bioethics. Drawing on EJ literature from the global South, the paper demonstrates that different ontological and experiential starting points identify additional EJ dimensions—power and harmony—and give rise to a nuanced understanding of the recognition dimension relative to the dominant EJ conception. The paper concludes by applying them to articulate healthcare sector responsibilities of justice to the environment, demonstrating they ground responsibilities beyond reducing its carbon emissions. (shrink)

Community engagement (CE) is gaining prominence in global health research. A number of ethical goals–spanning the instrumental, intrinsic, and transformative–have been ascribed to CE in global health research. This paper draws attention to an additional transformative value that CE is not typically linked to but that seems very relevant: solidarity. Both are concerned with building relationships and connecting parties that are distant from one another. This paper first argues that furthering solidarity should be recognized as another ethical goal for CE (...) in global health research. It contends that, over time, CE can build the bases of solidaristic relationships—moral imagination, recognition, understanding, empathy—between researchers and community members. Applying concepts from existing accounts of solidarity, the paper develops preliminary ideas about who should be engaged and how to advance solidarity. The proposed approach is compared to current CE practice in global health research. Finally, the paper briefly considers how solidaristic CE could affect how global health research is performed. (shrink)

The numerically definite syllogistic is the fragment of English obtained by extending the language of the classical syllogism with numerical quantifiers. The numerically definite relational syllogistic is the fragment of English obtained by extending the numerically definite syllogistic with predicates involving transitive verbs. This paper investigates the computational complexity of the satisfiability problem for these fragments. We show that the satisfiability problem (= finite satisfiability problem) for the numerically definite syllogistic is strongly NP-complete, and that the satisfiability problem (= finite (...) satisfiability problem) for the numerically definite relational syllogistic is NEXPTIME-complete, but perhaps not strongly so. We discuss the related problem of probabilistic (propositional) satisfiability, and thereby demonstrate the incompleteness of some proof-systems that have been proposed for the numerically definite syllogistic. (shrink)

In this paper, we show how the problem of accounting for the semanticsof temporal preposition phrases (tPPs) leads us to some surprisinginsights into the semantics of temporal expressions ingeneral. Specifically, we argue that a systematic treatment of EnglishtPPs is greatly facilitated if we endow our meaning assignments with context variables, a device which allows a tPP to restrict domainsof quantification arising elsewhere in a sentence. We observe that theuse of context variables implies that tPPs can modify expressions intwo ways, and (...) we use this observation to predict the behaviour of tPPswhose complements are themselves modified by other tPPs. (shrink)

Mind attribution may be divided into the subcategories of attribution of agency, associated with moral agency, and attribution of experience and emotion, associated with moral concern and moral patiency (Gray et al. Science 315(5812):619, 2007; Gray et al. Proceedings of the National Academy of Sciences of the United States of America 108(2):477–479, 2011b; Robbins and Jack Philosophical Studies 127(1):59–85, 2006). In this paper I attend to social context and the different psychological needs influencing the different types of mind attribution. A (...) need for social connection drives the attribution of experiences and emotions. The individual’s capacity to regulate emotional reactions is crucial for empathic concern. I further relate differences of mind attribution, attention, and emotional processing, to two different modes of functioning: In an interactive state of mind (comparable to the “second-person perspective” described by Schilbach et al. Behavioral and Brain Sciences, in press), social and emotional cues are attended to; In a detached task-oriented state of mind it may be beneficial to predict the behaviors of others but emotional information may not be attended to. The complexity and plasticity of mind attribution, including the possibility to train attentional mechanisms and regulation of emotions, is promising for the field of moral enhancement. (shrink)

ABSTRACT:Cities are struggling to balance the moral imperatives of sustainable development, with equity and social justice often ignored and negatively impacted by climate change mitigation and adaptation. Yet, the nature of these impacts on social justice has not been comprehensively investigated and little ethical guidance exists on how to better promote social justice in urban climate change planning practice. This article addresses the normative question: How should urban climate change planning advance social justice? It gathers empirical literature documenting the inclusivity (...) and equity impacts of urban climate change planning and thematically analyses that literature for dimensions of social justice drawn from philosophical and urban justice theory. Study findings demonstrate that four characteristics of climate change planning in cities—underlying neoliberal ideology, unequal treatment, green gentrification, and exclusion from decisionmaking—comprise, create, or worsen social injustices across six dimensions. These characteristics are often interconnected and inseparable. Where neoliberal ideology guides urban climate change planning, the other three characteristics frequently occur as well. The article concludes by arguing that, at a minimum, urban planners and climate planners have an obligation of justice to avoid undertaking climate change planning that exhibits any of the four characteristics and to address injustices generated where planning has such characteristics. It further suggests that planners' negative obligations likely extend beyond this because the literature review revealed gaps in existing empirical data on the equity impacts of urban climate change planning. (shrink)

Thus far, little work in bioethics has specifically focused on global health research priority-setting. Yet features of global health research priority-setting raise ethical considerations and concerns related to health justice. For example, such processes are often exclusively disease-driven, meaning they rely heavily on burden of disease considerations. They, therefore, tend to undervalue non-biomedical research topics, which have been identified as essential to helping reduce health disparities. In recognition of these ethical concerns and the limited scholarship and dialogue addressing them, we (...) convened an international workshop in September 2015. The workshop aimed to initiate discussion on the appropriate relationship between global and national levels of health research priority-setting and to begin exploring what might be ethically required for priority-setting at each of those levels. This paper comprises our reflections following the workshop. Its main objective is to launch a research agenda for the ethics of global health research priority-setting. We identify three domains of global health research priority-setting—scope, underlying values and substantive requirements, and procedural considerations. For each domain, specific research questions are highlighted and why they need to be explored is explained. Some preliminary thoughts and normative arguments as to how the research questions might be answered are also offered. For example, we provide initial ideas about the appropriate relationship between different priority-setting levels and what values and substantive considerations should guide or underpin global health research priority-setting as a matter of justice. We anticipate that framing a new research agenda for the ethics of global health research priority-setting will spur ethicists, researchers, and policymakers to refocus their efforts on developing more rigorous and ethically sound approaches to priority-setting. (shrink)

In recent years, there has been renewed interest in the development of formal languages for describing mereological (part-whole) and topological relationships between objects in space. Typically, the non-logical primitives of these languages are properties and relations such as ‘xis connected’ or ‘xis a part ofy’, and the entities over which their variables range are, accordingly, notpoints, butregions: spatial entities other than regions are admitted, if at all, only as logical constructs of regions. This paper considers two first-order mereotopological languages, and (...) investigates their expressive power. It turns out that these languages, notwithstanding the simplicity of their primitives, are surprisingly expressive. In particular, it is shown that infinitary versions of these languages are adequate to express (in a sense made precise below) all topological relations over the domain of polygons in the closed plane. (shrink)

The origin and the development of scientific disciplines has been a topic of reflection for several decades. The few extensive case studies support the thesis that scientific disciplines are not monolithic structures but can be characterized by distinct social, organizational and scientific–technical practices. Nonetheless, most disciplinary histories of genetics confine themselves largely to an uncontested account of the content of the discipline or occasionally institutional factors. Little attention is paid to the large number of researchers who, by their joint efforts, (...) ultimately shaped the discipline. We contribute to this aspect of disciplinary historiography by discussing the role of women researchers at the Institute for Heredity Research, founded in 1914 in Berlin under the directorship of Erwin Baur, and the sister of the John Innes Institute at Cambridge. This paper investigates how and why Baur built a highly successful research programme that relied on the efforts of his female staff, whose careers, notably Elisabeth Schiemann's, are also assessedin toto. These women undertook the necessary ‘technoscience’ and in some cases innovative work and helped increase the prestige of the institute and its director. Together they played a pivotal role in the establishment of genetics in Germany. Without them the discipline would have developed much more slowly and along a divergent path. (shrink)

In an environment characterized by the emergence of new and diverse (and often opposed) philosophical efforts, there is a need for a conception of philosophy that will promote the exchange and critical consideration of divergent insights. Depending upon the operative conception, philosophical efforts can be viewed as significant, insightful and instructive, or unimportant, misguided and not real philosophy. This paper develops John Dewey's conception of philosophy as a mode of inquiry in contrast with Bertrand Russell's conception of philosophy as a (...) mode of analysis. I argue that while Russell's analytic conception of philosophy justifies the dismissal of non-analytic philosophies, Dewey's conception of philosophy provides a theoretical framework for the comparison, evaluation and interaction of alternatives. (shrink)

By a fragment of a natural language, we understand a collection of sentences forming a naturally delineated subset of that language and equipped with a semantics commanding the general assent of its native speakers. By the semantic complexity of such a fragment, we understand the computational complexity of deciding whether any given set of sentences in that fragment represents a logically possible situation. In earlier papers by the first author, the semantic complexity of various fragments of English involving at most (...) transitive verbs was investigated. The present paper considers various fragments of English involving ditransitive verbs and determines their semantic complexity. (shrink)

In response to calls to expand the scope of research ethics to address justice in global health, recent scholarship has sought to clarify how external research actors from high-income countries might discharge their obligation to reduce health disparities between and within countries. An ethical framework—‘research for health justice’—was derived from a theory of justice (the health capability paradigm) and specifies how international clinical research might contribute to improved health and research capacity in host communities. This paper examines whether and how (...) external funders, sponsors, and researchers can fulfill their obligations under the framework. (shrink)

It has been suggested that community advisory boards can play a role in minimising exploitation in international research. To get a better idea of what this requires and whether it might be achievable, the paper first describes core elements that we suggest must be in place for a CAB to reduce the potential for exploitation. The paper then examines a CAB established by the Shoklo Malaria Research Unit under conditions common in resource-poor settings – namely, where individuals join with a (...) very limited understanding of disease and medical research and where an existing organisational structure is not relied upon to serve as the CAB. Using the Tak Province Border Community Ethics Advisory Board as a case study, we assess the extent to which it might be able to take on a role minimising exploitation were it to decide to do so. We investigate whether, after two years in operation, T-CAB is capable of assessing clinical trials for exploitative features and addressing those found to have them. The findings show that, although T-CAB members have gained knowledge and developed capacities that are foundational for one-day taking on a role to reduce exploitation, their ability to critically evaluate studies for the presence of exploitative elements has not yet been strongly demonstrated. In light of this example, we argue that CABs may not be able to perform such a role for a number of years after initial formation, making it an unsuitable responsibility for many short-term CABs. (shrink)

A sentence of first-order logic is satisfiable if it is true in some structure, and finitely satisfiable if it is true in some finite structure. The question arises as to whether there exists an algorithm for determining whether a given formula of first-order logic is satisfiable, or indeed finitely satisfiable. This question was answered negatively in 1936 by Church and Turing (for satisfiability) and in 1950 by Trakhtenbrot (for finite satisfiability).In contrast, the satisfiability and finite satisfiability problems are algorithmically solvable (...) for restricted subsets---or, as we say, fragments---of first-order logic, a fact which is today of considerable interest in Computer Science. This book provides an up-to-date survey of the principal axes of research, charting the limits of decision in first-order logic and exploring the trade-off between expressive power and complexity of reasoning. Divided into three parts, the book considers for which fragments of first-order logic there is an effective method for determining satisfiability or finite satisfiability. Furthermore, if these problems are decidable for some fragment, what is their computational complexity? Part I focusses on fragments defined by restricting the set of available formulas. Topics covered include the Aristotelian syllogistic and its relatives, the two-variable fragment, the guarded fragment, the quantifier-prefix fragments and the fluted fragment. Part II investigates logics with counting quantifiers. Starting with De Morgan's numerical generalization of the Aristotelian syllogistic, we proceed to the two-variable fragment with counting quantifiers and its guarded subfragment, explaining the applications of the latter to the problem of query answering in structured data. Part III concerns logics characterized by semantic constraints, limiting the available interpretations of certain predicates. Taking propositional modal logic and graded modal logic as our cue, we return to the satisfiability problem for two-variable first-order logic and its relatives, but this time with certain distinguished binary predicates constrained to be interpreted as equivalence relations or transitive relations. The work finishes, slightly breaching the bounds of first-order logic proper, with a chapter on logics interpreted over trees. (shrink)

An appeal to the inexplicable has always been a favourite tactic of the Supernaturalist; and even today those Supernaturalists that remain seem to derive some comfort from it. During the eighteenth and nineteenth centuries, for example, the orthodox Protestant apologetic in this country laid great stress on the ‘inexplicable’ events allegedly associated with Christ's life as anthenticating the truths of revelation. A more general thesis has been put forward as often, and even more often assumed: that the occurrence of inexplicable (...) events demonstrates the reality of a ‘spiritual’ realm. And in current literature we can find it claimed that the hegemony of science or the tenability of materialism is threatened by those inexplicabilities which are now known as the phenomena of ESP. (shrink)

How international research might contribute to justice in global health has not been substantively addressed by bioethics. This article describes how the provision of ancillary care can link international clinical research to the reduction of global health disparities. It identifies the ancillary care obligations supported by a theory of global justice, showing that Jennifer Ruger’s health capability paradigm requires the delivery of ancillary care to trial participants for a limited subset of conditions that cause severe morbidity and mortality. Empirical research (...) on the Shoklo Malaria Research Unit’s (SMRU) vivax malaria treatment trial was then undertaken to demonstrate whether and how these obligations might be upheld in a resource-poor setting. Our findings show that fulfilment of the ancillary care obligations is feasible where there is commitment from chief investigators and funders and is strongly facilitated by SMRU’s dual role as a research unit and medical non-governmental organization. (shrink)

John Henry Newman is widely acknowledged to be an important theologian. However Newman commentators suggest that his work has received little recognition by philosophers. The general consensus has been that until the latter part of the twentieth century Newman has been an isolated philosophical figure. This essay offers an historical re-evaluation of Newman's philosophical reception in order to explore whether or not his significance has been underestimated. The historical method is used in the analysis and assessment of this question. The (...) study therefore probes the general philosophical reaction to Newman's work in the nineteenth and early twentieth century. In doing so the essay offers an historical investigation and re-evaluation of the claims of Newman having a negligible philosophical legacy. (shrink)

Social justice has been identified as a foundational moral commitment for global health research ethics. Yet what a commitment to social justice means for community engagement in such research has not been critically examined. This paper draws on the rich social justice literature from political philosophy to explore the normative question: What should the ethical goals of community engagement be if it is to help connect global health research to social justice? Five ethical goals for community engagement are proposed that (...) promote well-being, agency, and self-development, particularly for those considered disadvantaged and marginalized. The paper also considers how key terms used in the proposed goals should be defined using existing theories of health and social justice. This analysis is done to give global health researchers and their partners a better idea of what the ethical goals mean. Patterns of convergence amongst different theories are identified that support relying on particular definitions of key terms. (shrink)

We study the fluted fragment, a decidable fragment of first-order logic with an unbounded number of variables, motivated by the work of W. V. Quine. We show that the satisfiability problem for this fragment has nonelementary complexity, thus refuting an earlier published claim by W. C. Purdy that it is in NExpTime. More precisely, we consider ${\cal F}{{\cal L}^m}$, the intersection of the fluted fragment and the m-variable fragment of first-order logic, for all $m \ge 1$. We show that, for (...) $m \ge 2$, this subfragment forces $\left\lfloor {m/2} \right\rfloor$-tuply exponentially large models, and that its satisfiability problem is $\left\lfloor {m/2} \right\rfloor$-NExpTime-hard. We further establish that, for $m \ge 3$, any satisfiable ${\cal F}{{\cal L}^m}$-formula has a model of at most -tuply exponential size, whence the satisfiability problem for this fragment is in -NExpTime. Together with other, known, complexity results, this provides tight complexity bounds for ${\cal F}{{\cal L}^m}$ for all $m \le 4$. (shrink)