How do multiple obligations to give, to receive, and to reciprocate contribute to the evolution of international society? This question can be derived from the works of the French anthropologist and sociologist Marcel Mauss, in particular from his classic essay The Gift, published in 1925. The aim of this article is to introduce Mauss’ theory of the gift to international political theorists, to develop a general theoretical argument from his claim about the universality of gift-giving, and to lay out the (...) plan of the Special Issue. First, we explore the basic concepts of gift-giving and reciprocity and how they highlight a type of exchange that differs from market exchange and from other forms of quid-pro-quo interactions. Second, we consider the Marshall Plan as an iconic and controversial example of international gift-giving. Third, we use Martin Wight’s division of international political thought into realism, rationalism, and revolutionism to locate the work of Mauss and neo-Maussian scholars within th... (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

Education and cognition research today generally recognize the tri-dimensional nature of reasoning processes as involving cognitive, social and emotional phenomena. However, there is so far no theoretical framework articulating these three dimensions from a descriptive perspective. This paper aims at presenting a first model of how group emotions work in collective reasoning, and specifies their social and cognitive functions. This model is inspired both from a multidisciplinary literature review and our extensive previous empirical work on an international corpus of videotaped (...) student debates. The cognitive function of emotions is defined in reference to the process of schematization and associated emotional framing. On the other hand, the social function of emotions refers to recognition-oriented behaviors that correspond to engagement into specific types of group talk, implying specific politeness rules or face-preservation systems. We believe that our multi-dimensional and multi-level approach to group reasoning, which mostly employs a linguistic perspective, can be applied to a diversity of contexts. We hope it will serve as a basis for further discussion on the role of emotions in reasoning among the interdisciplinary community of argumentation studies. (shrink)

In general, stimuli that are familiar and recognizable have an advantage of predominance during binocular rivalry. Recent research has demonstrated that familiar and recognizable stimuli such as upright faces and words in a native language could break interocular suppression faster than their matched controls. In this study, a visible word prime was presented binocularly then replaced by a high-contrast dynamic noise pattern presented to one eye and either a semantically related or unrelated word was introduced to the other eye. We (...) measured how long it took for target words to break from suppression. To investigate word-parts priming, a second experiment also included word pairs that had overlapping subword fragments. Results from both experiments consistently show that semantically related words and words that shared subword fragments were faster to gain dominance compared to unrelated words, suggesting that words, even when interocularly suppressed and invisible, can benefit from semantic and subword priming. (shrink)

We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.

This article examines the role of medical doctors, AI designers, and other stakeholders in making applied AI and machine learning ethically acceptable on the general premises of shared decision-making in medicine. Recent policy documents such as the EU strategy on trustworthy AI and the research literature have often suggested that AI could be made ethically acceptable by increased collaboration between developers and other stakeholders. The article articulates and examines four central alternative models of how AI can be designed and applied (...) in patient care, which we call the ordinary evidence model, the ethical design model, the collaborative model, and the public deliberation model. We argue that the collaborative model is the most promising for covering most AI technology, while the public deliberation model is called for when the technology is recognized as fundamentally transforming the conditions for ethical shared decision-making. (shrink)

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

Unintended negative outcomes on child behavior due to lockdown and home confinement following the corona virus disease pandemic needs highlighting to effectively address these issues in the current and future health crises. In this sub-study of the ODIN-study, the objectives were to determine whether the Danish lockdown and home confinement following the COVID-19 pandemic affected changes in emotional-behavioral functioning of pre-school-aged children using the validated Strength and Difficulties Questionnaire answered by parents shortly before lockdown and 3 weeks into lockdown, and (...) moreover, to examine whether baseline family and social characteristics could predict change in child emotional-behavioral functioning during lockdown. Parents of 40 children with a mean age of 5.0 completed the baseline questionnaire and the lockdown follow-up questionnaire. The SDQ-Total difficulties score and Prosocial Behavioral score changed significantly from pre- to lockdown [SDQ-TD mean: 6.0 and 7.9; P = 0.02, respectively and PSB mean: 8.5 and 7.9; P = 0.03, respectively]. Attending leisure time activities before lockdown was a predicting factor of changes to the worse in the children’s SDQ-TD scores, with a mean difference in SDQ-TD between those with and without activities of 3.16 ; P = 0.03. In conclusion, the study showed a modest decrease in child-emotional behavioral functioning during the COVID-19 lockdown, potentially due to parental stress. Although these results might not be generalizable due to small sample size and selected population, the results point to a need of a greater awareness of child mental wellbeing during a lockdown situation. (shrink)

The relationship between gender and ethics has been extensively researched. However, previous studies have assumed that the gender–ethics association is constant; hence, scholars have seldom investigated factors potentially affecting the gender–ethics association. Thus, using managers as the research target, this study examined the relationship between gender and ethics and analyzed the moderating effect of cultural values on the gender–ethics association. The results showed that, compared with female managers, their male counterparts are more willing to justify business-related unethical behaviors such as (...) bribery and tax evasion, and that the gender difference in ethics becomes more pronounced under the cultural dimensions of collectivism, humane orientation, performance orientation, and gender egalitarianism. This study used data obtained through surveying 2,754 managers in 27 nations. (shrink)

BackgroundThe use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers’ use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers’ use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium on the use of (...) genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023.MethodsA realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available.DiscussionThe A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders. (shrink)

Machine learning and other forms of artificial intelligence can improve parts of clinical decision making regarding the gathering and analysis of data, the detection of disease, and the provis...

The objective of this article is to explore people’s attitudes toward responsibility in the allocation of public health care resources. Special attention is paid to conceptualizations of responsibility involving blame and sanctions. A representative sample of the Norwegian population was asked about various responsibility mechanisms that have been proposed in the theoretical literature on health care and personal responsibility, from denial of treatment to a tax on unhealthy consumer goods. Survey experiments were employed to study treatment effects, such as whether (...) fairness considerations affect attitudes about responsibility. We find that, overall, a substantial minority of the respondents find it fair to let the health care system sanction people—in one way or another—for voluntary behaviors that increase the risk of becoming ill. Quite surprisingly, we find that people are more prone to report that they should themselves be held responsible for unhealthy lifestyles than others. (shrink)

BackgroundResearch proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?Main textWhen researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions (...) can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.ConclusionWith this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects. (shrink)

Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Current debate and policy surrounding the use of genetic editing in humans often relies on a binary distinction between therapy and human enhancement. In this paper, we argue that this dichotomy fails to take into account perhaps the most significant potential uses of CRISPR-Cas9 gene editing in humans. We argue that genetic treatment of sporadic Alzheimer’s disease, breast- and ovarian-cancer causing BRCA1/2 mutations and the introduction of HIV resistance in humans should be considered within a new category of genetic protection (...) treatments. We find that if this category is not introduced, life-altering research might be unnecessarily limited by current or future policy. Otherwise ad hoc decisions might be made, which introduce a risk of unforeseen moral costs, and might overlook or fail to address some important opportunities. (shrink)

Reducing inequalities in health and the determinants of health is a widely acknowledged health policy goal, and methods for measuring inequalities and inequities in health are well developed. Yet, the evidence base is weak for how to achieve these goals. There is a lack of high-quality randomised controlled trials reporting impact on the distribution of health and non-health benefits and lack of methodological rigour in how to design, power, measure, analyse and interpret distributional impact in RCTs. Our overarching aim in (...) this paper is to contribute to the emerging effort to improve transparency and coherence in the theoretical and conceptual basis for RCTs on effective interventions to reduce health inequity. We endeavour to achieve this aim by pursuing two more specific objectives. First, we propose an overview of three broader health equity frameworks and clarify their implications for the measurement of health inequality in RCTs. Second, we seek to clarify the relationship between theory and translational challenges that researchers would need to attend to, in order to ensure that equity-relevant RCTs are coherently grounded in theory. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Handeln, Personsein, Menschenwürde und zahlreiche Fragen der Angewandten Ethik – das ist das weite Spektrum dieser Festschrift und auch des Denkens von Ralf Stoecker, dem sie gewidmet ist. Ganz in seinem Geiste laden die Beiträge des Bandes dazu ein, zusammen zu denken und zusammenzudenken, was – möglicherweise – zusammengehört.

Handeln, Personsein, Menschenwürde und zahlreiche Fragen der Angewandten Ethik – das ist das weite Spektrum dieser Festschrift und auch des Denkens von Ralf Stoecker, dem sie gewidmet ist. Ganz in seinem Geiste laden die Beiträge des Bandes dazu ein, zusammen zu denken und zusammenzudenken, was – möglicherweise – zusammengehört.

The welfare of farmed fish is often regarded with less concern than the welfare of other husbandry animals, as fish are not universally classified as sentient beings. In Norway, farmed fish and other husbandry animals are legally protected under the same laws. Additionally, the legislature has defined a number of aquaculture-specific amendments, including mandatory welfare courses for fish farmers who have a key role in securing animal welfare, also with regards to noting welfare challenges in the production process. This article (...) uses fish welfare courses as a site from which to inquire about the common-sense understanding of fish welfare in Norwegian fish farming. The focus is specifically on fish farm employees, their experiences of welfare-related issues and contradictions in their daily work, and the struggle to act responsibly in aquaculture settings. Through participant observation at welfare courses, as well as interviews and conversations with fish farm workers, the article details how challenges are experienced ‘on the ground’, and suggests how fish farm workers’ own experiential knowledge might be mobilized to improve the general welfare of farmed fish. (shrink)

In much the same way that genomic technologies are changing the complexion of biomedical research, the issues they generate are changing the agenda of IRBs and research ethics. Many of the biggest challenges facing traditional research ethics today — privacy and confidentiality of research subjects; ownership, control, and sharing of research data; return of results and incidental findings; the relevance of group interests and harms; the scope of informed consent; and the relative importance of the therapeutic misconception — have become (...) important policy issues over the last 20 years because of the ways they have been magnified by genomic research efforts. Research that examines the ethical, legal, and social implications of human genomics research has become a burgeoning international field of scholarship over the last 20 years, thanks in part to its support first by the genome research funding bodies in the U.S. and then by national science agencies in other countries. (shrink)

Background Rationing and allocation decisions at the clinical level – bedside rationing – entail complex dilemmas that clinicians and managers often find difficult to handle. There is a lack of mechanisms and aids for promoting fair decisions, especially in hard cases. Reports indicate that clinical ethics committees sometimes handle cases that involve bedside rationing dilemmas. Can CECs have a legitimate role to play in bedside rationing? Main text Aided by two frameworks for legitimate priority setting, we discuss how CECs can (...) contribute to enhanced epistemic, procedural and political legitimacy in bedside rationing decisions. Drawing on previous work we present brief case vignettes and outline several potential roles that CECs may play, and then discuss whether these might contribute to rationing decisions becoming legitimate. In the process, key prerequisites for such legitimacy are identified. Legitimacy places demands on aspects such as the CEC’s deliberation process, the involvement of stakeholders, transparency of process, the opportunity to appeal decisions, and the competence of CEC members. On these conditions, CECs can help strengthen the legitimacy of some of the rationing decisions clinicians and managers have to make. Conclusions On specified conditions, CECs can have a well-justified advisory role to play in order to enhance the legitimacy of bedside rationing decisions. (shrink)

The labor market is an area with diverse data structures and multiple applications, such as matching job seekers with the right training or job. For this reason, the multilingual classification of European Skills, Competences, Qualifications and Occupations (ESCO) is a good example of the central role of ontologies in this area. However, ESCO cannot provide all the details of local labor market needs and does not provide links to other hierarchies of competences. For example, other taxonomies of occupations and skills (...) are widely used in German-speaking countries, but they are not in a state where they are easily accessible for interoperability and reasoning. In this paper, we present a first version of a German Labor Market Ontology (GLMO) that uses ESCO as a top-level ontology for the target domain. This makes it highly interoperable and comparable to existing ontologies by providing details for the regional structures in German-speaking countries. In addition, we present a detailed evaluation of the provided data and applications, as well as an extensive discussion of future work. (shrink)

Background In the context of limited health care budgets in countries where Neglected Tropical Diseases are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. Objectives The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi-criteria decision-making matrix, and (...) 3) discuss the conditions under which this decision-making procedure should be carried out in a real-world decision-making context. Methods This paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi-criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases. Discussion Our in vitro multi-criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil-transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision-making process and we stress the limitations of this study exercise. Conclusion By exploring how several criteria relevant to the multi-facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

Several philosophers claim that the greenhouse gas emissions from actions like a Sunday drive are so miniscule that they will make no difference whatsoever with regard to anthropogenic global climate change (AGCC) and its expected harms. This paper argues that this claim of individual causal inefficacy is false. First, if AGCC is not reducible at least in part to ordinary actions, then the cause would have to be a metaphysically odd emergent entity. Second, a plausible (dis-)utility calculation reveals that such (...) actions have a not-insignificant amount of expected harm. One upshot is that the near-exclusive focus in the literature on AGCC as a collective action problem is too restricted. The paper also provides several moral psychological explanations of why it is so difficult to comprehend individual responsibility with regard to global phenomena, including a reappraisal of Thomas Nagel’s view of the absurd. (shrink)

The concept of legitimacy is often used and emphasized in the context of setting limits in health care, but rarely described is what is actually meant by its use. Moreover, it is seldom explicitly stated how health-care workers can contribute to the matter, nor what weight should be apportioned to their viewpoints. Instead the discussion has focused on whether they should take on the role of the patients’ advocate or that of gatekeeper to the society’s resources. In this article, we (...) shed light on the role of health-care workers in limit setting and how their conferred legitimacy may support subordinators’ (i.e. citizens’) conferred legitimacy. We argue that health-care workers have an important role to play as both moral and political agents in limit setting, and delineate normative conditions that justify and facilitate health-care workers in conferring legitimacy on this kind of decision. Their role and potential impact on political limit setting does not—theoretically—affect the idea of democratic legitimacy negatively. Rather, as we suggest, by designing for limit-setting policymaking accordingly, health-care workers, as well as citizens, are more justified in conferring democratic legitimacy to health-care limit-setting decisions than if these concerns were not addressed. (shrink)

Ellen Gleditsch (1879–1968) became Norway’s first authority on radioactivity and the country’s second female full professor. From her many years abroad—in Marie Curie’s laboratory in Paris and at Yale University in New Haven with Bertram Boltram—she became internationally acknowledged and developed an extensive personal and scientific network. In the Norwegian scientific community she was, however, less appreciated, and her appointment as a professor in 1929 caused controversy. Despite the recommendation of the expert committee, her predecessor and his allies spread the (...) view that Gleditsch was a diligent but outdated researcher with little scientific promise—a view that apparently persists in the Norwegian chemical community today. In addition to her scientific work, Gleditsch acquired political influence by joining the International Federation of University Women in 1920; she later became the president of both the Norwegian section and the worldwide organization. She worked in particular to establish scholarships enabling women to go abroad. I once worked with a learned man who was reputed to hate women. On one occasion he stated that the new collaborator was a rare exception. When he was asked why he said, “She does not scream.” I heard this several months later and have kept it as a great compliment; yes—the biggest in my scientific career. —Ellen Gleditsch. (shrink)

In this article, we re-examine Pascal’s Mugging, and argue that it is a deeper problem than the St. Petersburg paradox. We offer a way out that is consistent with classical decision theory. Specifically, we propose a “many muggers” response analogous to the “many gods” objection to Pascal’s Wager. When a very tiny probability of a great reward becomes a salient outcome of a choice, such as in the offer of the mugger, it can be discounted on the condition that there (...) are other symmetric, non-salient rewards that one may receive if one chooses otherwise. (shrink)

This paper consists of a detailed analysis of how the participants in a debate build their emotional position during the interaction and how such a position is strongly related to the conclusion they defend. In this case study, teenage Mexican, students, arguing about access to drinking water, display extensive discursive work on the emotional tonality given to the issue. Plantin’s methodological tools are adopted to follow two alternative emotional framings produced by disagreeing students, starting from a common, highly negative, thymic (...) tonality. Through the analysis of four parameters we describe how the emotional dimension of schematization is argumentatively relevant. In authentic discourse, it is impossible to separate emotion from reason. The conclusion section discusses the implications for the design of argumentation-based pedagogical activities. (shrink)

Each contributor to this book has used personal experience as the basis from which to frame his individual sociological perspectives. Because they have personalized their work, their accounts are real, and recognizable as having come from 'real' persons, about 'real' experiences. There are no objectively-distanced disembodied third person entities in these accounts. These writers are actual people whose stories will make you laugh, cry, think, and want to know more.

Agitation is one of the most common behavioural and psychological symptoms in people living with dementia. This behaviour can cause tremendous stress and anxiety on family caregivers and healthcare providers. Direct observation of PLwD is the traditional way to measure episodes of agitation. However, this method is subjective, bias-prone and timeconsuming. Importantly, it does not predict the onset of the agitation. Therefore, there is a need to develop a continuous monitoring system that can detect and/or predict the onset of agitation. (...) In this study, a multi-modal sensor platform with video cameras, motion and door sensors, wristbands and pressure mats were set up in a hospital-based dementia behavioural care unit to develop a predictive system to identify the onset of agitation. The research team faced several barriers in the development and initiation of the study, namely addressing concerns about the study ethics, logistics and costs of study activities, device design for PLwD and limitations of its use in the hospital. In this paper, the strategies and methodologies that were implemented to address these challenges are discussed for consideration by future researchers who will conduct similar studies in a hospital setting. (shrink)

There is some consensus that for S to know that p, it cannot be merely a matter of luck that S’s belief that p is true. This consideration has led Duncan Pritchard and others to propose a safety condition on knowledge. In this paper, we argue that the safety condition is not a proper formulation of the intuition that knowledge excludes luck. We suggest an alternative proposal in the same spirit as safety, and find it lacking as well.

We have long lived in a world made by global connections. Our products, our travels, our ideas--all of these have their origins in places and peoples both near and far. But when scholars narrate the history of the modern self, they ignore these connections and focus on changes in European science and philosophy. In this provocative new book, Avram Alpert argues that we need to rethink the story of the modern self as a global history. He first shows how (...) canonical European thinkers like Michel de Montaigne, René Descartes, and Immanuel Kant explicitly formed their ideas of selfhood in relation to the travel accounts flooding into Europe from colonial missionaries. He then pushes this history beyond Europe, showing how a diverse series of writers, including Ralph Waldo Emerson, W.E.B. Du Bois, Léopold Senghor, Frantz Fanon, and D.T. Suzuki, critiqued these ideas of global selfhood with their own creative responses. Spanning four continents and four centuries, the book argues that all of these writers partake of a shared global history forged in the violence of colonial rule. The resulting narrative shows that the modern self is not a European invention, but a global, evolving, and fraught attempt to make ourselves the kinds of beings who can live with the complexity of a world that is at once connected and never fully knowable. (shrink)

I Norge er ikke surrogati tillatt, og myndighetene fraråder norske statsborgere å benytte seg av surrogati i utlandet. I denne artikkelen fokuserer vi på kommersiell gestational surrogati og stiller spørsmålet: Bør man tillate at norske statsborgere benytter seg av surrogati i India? De etiske problemstillingene rundt surrogati er mange og sammensatte og blir spesielt utfordrende når tjenesten tilbys i et land med store kulturelle og økonomiske forskjeller både internt og i forhold til Norge. Vi baserer analysen og drøftingen av dette (...) etisk utfordrende spørsmålet på Beauchamps og Childress sin veletablerte metodiske tilnærming innen biomedisinsk etikk. Vi anvender de fire allmennmoralske prinsipper: respekt for autonomi, velgjørenhet, ikke-skade og rettferdighet på sakskomplekset for å synliggjøre spenningene involvert i dette etiske dilemmaet. Med full bevissthet om at det ikke finnes noen lettvinte og omkostningsfrie løsninger på dilemmaer generelt og dette spesielt, konkluderer vi med at interessene til de berørte parter, og spesielt surrogatmødrenes, kan bli bedre ivaretatt om surrogati tillates under omfattende reguleringer. Dersom man velger å gjøre praksisen illegal, vil man også miste mulighetene til å påvirke prosessen og sikre rettighetene til de involverte partene.Nøkkelord: surrogati, Norge–India, utnyttelse, autonomi, regulering av prosessenEnglish summary: Should Norwegian citizens be permitted to use surrogacy in India?Surrogacy is not permitted in Norway, and the government strongly advises against Norwegian citizens travelling abroad to have children through the use of the surrogacy industry. In this article, we focus on commercial gestational surrogacy and debate the question: Should Norwegian citizens be permitted to use surrogacy in India? The ethical concerns regarding surrogacy are complex and are especially challenging when the service is offered in a country with big cultural and economic differences both internal and in comparison to Norway. We base our analysis of this ethical, challenging question on Beauchamp’s and Childress’s well-established approach within biomedical ethics. We apply the four principles of respect for autonomy, beneficence, nonmaleficence and justice to shed light on the conflicts of interests in this ethical dilemma. With full awareness that there are no simple and correct solutions to dilemmas in general and on this issue, especially, our conclusion is that the interests of the involved parties, and especially those of the surrogate mothers, might be better attended to if surrogacy is allowed with extensive regulations. If this practice is made illegal, the opportunity to influence the process and secure the rights of the involved parties is lost. (shrink)

Protecting the public's health has recently regained prominence in political and public discussions. Threats of bioterrorism following September 11, 2001 and the deliberate dissemination of anthrax later that fall, the reemergence of novel or resurgent infectious diseases, and rapid increases in diseases associated with sedentary lifestyles, poor diets, and smoking have all raised the profile of public health. The U.S. government has responded with increased funding, reorganization, and new policies for the population's health, safety, and security. Politicians and the public (...) more clearly understand the importance of law in improving the public's health. Recognizing that many public health laws have not been meaningfully reformed in decades, law- and policy-makers and public health practitioners have focused on the legal foundations for public health. Laws provide the mission, functions, and powers of public health agencies, set standards for their actions, and safeguard individual rights. (shrink)

Law is an essential tool for improving public health infrastructure and outcomes; however, existing state statutory public health laws may be insufficient. Built over decades in response to various diseases/conditions, public health laws are antiquated, divergent, and confusing. The Turning Point Public Health Statute Modernization National Collaborative addressed the need for public health law reform by producing a comprehensive model state act. The Act provides scientifically, ethically, and legally sound provisions on public health infrastructure, powers, duties, and practice. This article (...) examines how statutory law can be a tool for improving the public's health, existing needs for public health law reform, themes and provisions of the Turning Point Act, and how it is being used by public health practitioners. (shrink)

Background Posthumous organ procurement is hindered by the consenting process. Several consenting systems have been proposed. There is limited information on public relative attitudes towards various consenting systems, especially in Middle Eastern/Islamic countries. Methods We surveyed 698 Saudi Adults attending outpatient clinics at a tertiary care hospital. Preference and perception of norm regarding consenting options for posthumous organ donation were explored. Participants ranked (1, most agreeable) the following, randomly-presented, options from 1 to 11: no-organ-donation, presumed consent, informed consent by donor-only, (...) informed consent by donor-or-surrogate, and mandatory choice; the last three options ± medical or financial incentive. Results Mean(SD) age was 32(9) year, 27% were males, 50% were patients’ companions, 60% had ≥ college education, and 20% and 32%, respectively, knew an organ donor or recipient. Mandated choice was among the top three choices for preference of 54% of respondents, with an overall median[25%,75%] ranking score of 3[2,6], and was preferred over donor-or-surrogate informed consent (4[2,7], p vs. 11[6,11], respectively, p = 0.002). Compared to females, males more perceived donor-or-surrogate informed consent as the norm (3[1,6] vs. 5[3,7], p vs. 8[4,9], p vs. 5[2,7], p Conclusions We conclude that: 1) most respondents were in favor of posthumous organ donation, 2) mandated choice system was the most preferred and presumed consent system was the least preferred, 3) there was no difference between preference and perception of norm in consenting systems ranking, and 4) financial (especially in females) and medical (especially in males) incentives reduced preference. (shrink)

Mounting evidence suggests that participation in clinical trials confers neither advantage nor disadvantage on those enrolled. Narrow focus on the question of a “trial effect,” however, distracts from a broader mechanism by which patients may benefit from ongoing clinical research. We hypothesize that the existence of clinical trials infrastructure—the organizational culture, systems, and expertise that develop as a product of sustained participation in cooperative clinical trials research—may function as a quality improvement lever, improving the quality of care and outcomes of (...) all patients within an institution or region independent of their individual participation in trials. We further contend that this “infrastructure effect” can yield particular benefits for patients in low- and middle-income countries. The hypothesis of an infrastructure effect as a quality improvement intervention, if correct, justifies enhanced research capacity in LMIC as a pillar of health system development. (shrink)

To what extent do we value future generations? It may seem from our behavior that we don’t value future generations much at all, at least in relation to how much we value present generations. However, in his book _Death and the Afterlife_, Samuel Scheffler argues that we value the future even _more_ than we value the present, even though this is not immediately apparent to us. If Scheffler’s argument is sound, then it has important ramifications: It would give us a (...) strong motivation to put more energy into abating environmental crises like climate change, and it supports at least a limited form of ethical _longtermism_. However, in this paper, I show that Scheffler’s argument is fallacious. Scheffler claims that we do not regard the fact that we in the present generation will all die relatively soon as a catastrophe, but we do regard the non-existence of future generations as a catastrophe. But the particular scenario used by Scheffler to illustrate this point—the plot of the book _The Children of Men_—is one in which _both_ the present generation will perish _and_ there will be no future generations, and it is this _conjunction_ that is catastrophic, thus giving no information about which is worse. I suggest other ways to compare our valuations of present and future generations, and recommend that philosophers who are interested in the moral psychology of how we value future generations ought to engage with social science, as it is an empirical issue. (shrink)

There has been much work on ontological dependence in recent literature. However, relatively little of it has been dedicated to the ways in which individual physical objects may depend on other distinct, non-overlapping objects. This paper gives several examples of such object-dependence and distinguishes between different types of it. The paper also introduces and refines the notion of an n-tet. N-tets (typically) occur when there are object-dependence relations between n objects. I claim that the identity (or, rather, what I call (...) the n-dentity) conditions for n-tets are not grounded in the individual identity conditions of each of the n objects, but instead are metaphysically basic. The paper then briefly discusses some ramifications of accepting object-dependence (and n-tets) on the philosophy of biology, ethics, and logic. (shrink)

In this article, the author argues that the works of Immanuel Kant and Henry David Thoreau can help reframe current political discussions about violence and nonviolence within revolutionary movements. For both of them, the means and ends of political change must coincide. Since they seek a nonviolent state of affairs, each argues against violent political change. However, they are also concerned to articulate a relationship between armed and unarmed struggle. After all, Kant and Thoreau worked to find what was positive (...) in violent acts: the French Revolution and John Brown’s raid on Harpers Ferry, respectively. They suggest that one of the ethical acts of revolutionary nonviolence is the sympathetic spectatorship of comrades in struggle who have chosen violent means. This opens up a theory of revolutionary nonviolence as a dual injunction to remain resolutely opposed to violence, but also to be capable of finding within violent acts a deeper desire for the end of violence. (shrink)

This paper contributes to a growing body of literature analyzing the social responsibilities of SMEs (Sarbutts, 2003, Journal of Communication Management 7(4), 340-347; Castka et al., 2004, Corporate Social Responsibility and Environmental Management 11, 140-149; Enderle, 2004, Business Ethics: A European Review 14(1), 51-63; Fuller and Tian, 2006, Journal of Business Ethics 67, 287-304; Jenkins, 2006, Journal of Business Ethics 67, 241-256; Lepoutre and Heene, 2006, Journal of Business Ethics 67, 257-273; Roberts, 2003, Journal of Business Ethics 44(2), 159-170; Williamson (...) et al., 2006, Journal of Business Ethics 67, 317-330) by designing a conceptual framework based on the Strategic Management Theory, which links social issues to the creation of sustained competitive advantages for SMEs. Firstly, the paper reviews literature on corporate social responsibility (CSR) and especially on the creation of social capital for SMEs. An exploration of Strategic Management Theory follows, focusing on the Positioning and Competence Based Schools, with the objective to find an answer to the question: how do social and environmental issues fit in the logic of creation of competitive advantage and what role do they play during strategic planning? The contributions of Hart (natural resourced based view) and Porter and Kramer (development of strategic intent in social responsible actions) are then related to the framework of possible growth paths of SMEs (Hong and Jeong, 2006, Journal of Enterprise Information Management 19(3), 292-302) in order to answer this question. Strategies that could trigger or lever these growth paths are then discussed. Following the recommendation Thompson and Smith (1991, Journal of Small Business Management 29(1), 30-44) gave to focus on the "study of CSR behaviors instead of perceptions," a medium-sized Austrian company in the food producing industry has been identified for an exploratory case study analysis to test the applicability of this theoretical framework for the description of the actual responsible business behavior (RBB) of an SME. This company is typical of one of the 250.000 SMEs which account for 99.6% of the Austrian economy. Based on the findings and the discussion, this paper presents a strategic planning tool for SMEs aiming to embed RBB into the corporate strategy. (shrink)

Gignac and Zajenkowski (2020) find that “the degree to which people mispredicted their objectively measured intelligence was equal across the whole spectrum of objectively measured intelligence”. This Comment shows that Gignac and Zajenkowski’s (2020) finding of homoscedasticity is likely the result of a recoding choice by the experimenters and does not in fact indicate that the Dunning-Kruger Effect is a mere statistical artifact. Specifically, Gignac and Zajenkowski (2020) recoded test subjects’ responses to a question regarding self-assessed comparative IQ onto a (...) linear IQ scale when a normal IQ scale would likely have been more appropriate. More generally, researchers studying self-assessed intelligence should be aware of potential measurement problems that may arise when transforming an ordinal scale onto an interval scale. (shrink)

Les auteurs publient huit tablettes de malédiction de plomb conservées d'une manière plus ou moins fragmentaire, trouvées fortuitement dans la nécropole tumulaire d'Istros et datant du IVe siècle av. J.-C. La première est manifestement une defixio iudiciaria, les nos 2-4 sont des listes de noms (sans doute toujours des defixiones iudiciariae), les nos 5-7 sont presque illisibles, alors que le n° 8 est un couvercle de plomb inscrit. Le texte le plus important est révélé par le n° 1. Le commentaire (...) porte surtout sur le verbum devotorium γράφειν, la forme συνεπιόντων, les personnes concernées par la malédiction et leurs noms. Les nos 2-3 révèlent plusieurs anthroponymes plutôt rares commentés en détail. Le n° 8 semble être un fragment d'une cassette de plomb qui aurait pu abriter une « figurine vaudou ». On ne connaissait jusqu'ici que cinq cassettes de ce genre : quatre en Attique et une en mer Noire. (shrink)